|
PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$1,003.00
|
|
|
Service Code
|
HCPCS 44363
|
| Min. Negotiated Rate |
$108.20 |
| Max. Negotiated Rate |
$752.25 |
| Rate for Payer: Aetna Commercial |
$224.14
|
| Rate for Payer: Aetna Medicare |
$167.27
|
| Rate for Payer: BCBS Complete |
$113.61
|
| Rate for Payer: BCBS MAPPO |
$167.27
|
| Rate for Payer: BCN Commercial |
$281.86
|
| Rate for Payer: BCN Medicare Advantage |
$167.27
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cofinity Commercial |
$240.87
|
| Rate for Payer: Cofinity Commercial |
$224.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.27
|
| Rate for Payer: Healthscope Commercial |
$200.72
|
| Rate for Payer: Healthscope Whirlpool |
$200.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.63
|
| Rate for Payer: Meridian Medicaid |
$113.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.00
|
| Rate for Payer: Nomi Health Commercial |
$200.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.25
|
| Rate for Payer: PACE SWMI |
$167.27
|
| Rate for Payer: PHP Medicare Advantage |
$167.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$343.42
|
| Rate for Payer: Priority Health Medicare |
$167.27
|
| Rate for Payer: Priority Health Narrow Network |
$343.42
|
| Rate for Payer: Railroad Medicare Medicare |
$167.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$338.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$167.27
|
| Rate for Payer: UHC Exchange |
$338.46
|
| Rate for Payer: UHC Medicaid |
$108.20
|
| Rate for Payer: UHCCP DNSP |
$167.27
|
| Rate for Payer: UHCCP Medicaid |
$108.20
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$1,154.00
|
|
|
Service Code
|
HCPCS 44365
|
| Min. Negotiated Rate |
$102.67 |
| Max. Negotiated Rate |
$865.50 |
| Rate for Payer: Aetna Commercial |
$212.54
|
| Rate for Payer: Aetna Medicare |
$158.61
|
| Rate for Payer: BCBS Complete |
$107.80
|
| Rate for Payer: BCBS MAPPO |
$158.61
|
| Rate for Payer: BCN Commercial |
$268.41
|
| Rate for Payer: BCN Medicare Advantage |
$158.61
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cofinity Commercial |
$228.40
|
| Rate for Payer: Cofinity Commercial |
$212.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.61
|
| Rate for Payer: Healthscope Commercial |
$190.33
|
| Rate for Payer: Healthscope Whirlpool |
$190.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.54
|
| Rate for Payer: Meridian Medicaid |
$107.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.47
|
| Rate for Payer: Nomi Health Commercial |
$190.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$865.50
|
| Rate for Payer: PACE SWMI |
$158.61
|
| Rate for Payer: PHP Medicare Advantage |
$158.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$327.05
|
| Rate for Payer: Priority Health Medicare |
$158.61
|
| Rate for Payer: Priority Health Narrow Network |
$327.05
|
| Rate for Payer: Railroad Medicare Medicare |
$158.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.61
|
| Rate for Payer: UHC Exchange |
$320.00
|
| Rate for Payer: UHC Medicaid |
$102.67
|
| Rate for Payer: UHCCP DNSP |
$158.61
|
| Rate for Payer: UHCCP Medicaid |
$102.67
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE
|
Professional
|
Both
|
$1,154.00
|
|
|
Service Code
|
HCPCS 44364
|
| Min. Negotiated Rate |
$115.02 |
| Max. Negotiated Rate |
$865.50 |
| Rate for Payer: Aetna Commercial |
$238.21
|
| Rate for Payer: Aetna Medicare |
$177.77
|
| Rate for Payer: BCBS Complete |
$120.77
|
| Rate for Payer: BCBS MAPPO |
$177.77
|
| Rate for Payer: BCN Commercial |
$300.78
|
| Rate for Payer: BCN Medicare Advantage |
$177.77
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cofinity Commercial |
$255.99
|
| Rate for Payer: Cofinity Commercial |
$238.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.77
|
| Rate for Payer: Healthscope Commercial |
$213.32
|
| Rate for Payer: Healthscope Whirlpool |
$213.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.66
|
| Rate for Payer: Meridian Medicaid |
$120.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.55
|
| Rate for Payer: Nomi Health Commercial |
$213.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$865.50
|
| Rate for Payer: PACE SWMI |
$177.77
|
| Rate for Payer: PHP Medicare Advantage |
$177.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$366.48
|
| Rate for Payer: Priority Health Medicare |
$177.77
|
| Rate for Payer: Priority Health Narrow Network |
$366.48
|
| Rate for Payer: Railroad Medicare Medicare |
$177.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$360.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.77
|
| Rate for Payer: UHC Exchange |
$360.44
|
| Rate for Payer: UHC Medicaid |
$115.02
|
| Rate for Payer: UHCCP DNSP |
$177.77
|
| Rate for Payer: UHCCP Medicaid |
$115.02
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO DCMPRN
|
Professional
|
Both
|
$2,847.00
|
|
|
Service Code
|
HCPCS 44021
|
| Min. Negotiated Rate |
$579.57 |
| Max. Negotiated Rate |
$2,135.25 |
| Rate for Payer: Aetna Commercial |
$1,212.08
|
| Rate for Payer: Aetna Medicare |
$904.54
|
| Rate for Payer: BCBS Complete |
$608.55
|
| Rate for Payer: BCBS MAPPO |
$904.54
|
| Rate for Payer: BCN Commercial |
$1,464.57
|
| Rate for Payer: BCN Medicare Advantage |
$904.54
|
| Rate for Payer: Cash Price |
$2,277.60
|
| Rate for Payer: Cash Price |
$2,277.60
|
| Rate for Payer: Cofinity Commercial |
$1,302.54
|
| Rate for Payer: Cofinity Commercial |
$1,212.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.54
|
| Rate for Payer: Healthscope Commercial |
$1,085.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,085.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.77
|
| Rate for Payer: Meridian Medicaid |
$608.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.99
|
| Rate for Payer: Nomi Health Commercial |
$1,085.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,135.25
|
| Rate for Payer: PACE SWMI |
$904.54
|
| Rate for Payer: PHP Medicare Advantage |
$904.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$579.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,784.47
|
| Rate for Payer: Priority Health Medicare |
$904.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,784.47
|
| Rate for Payer: Railroad Medicare Medicare |
$904.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,737.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$904.54
|
| Rate for Payer: UHC Exchange |
$1,737.23
|
| Rate for Payer: UHC Medicaid |
$579.57
|
| Rate for Payer: UHCCP DNSP |
$904.54
|
| Rate for Payer: UHCCP Medicaid |
$579.57
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL
|
Professional
|
Both
|
$3,034.00
|
|
|
Service Code
|
HCPCS 44020
|
| Min. Negotiated Rate |
$583.62 |
| Max. Negotiated Rate |
$2,275.50 |
| Rate for Payer: Aetna Commercial |
$1,220.18
|
| Rate for Payer: Aetna Medicare |
$910.58
|
| Rate for Payer: BCBS Complete |
$612.80
|
| Rate for Payer: BCBS MAPPO |
$910.58
|
| Rate for Payer: BCN Commercial |
$1,466.05
|
| Rate for Payer: BCN Medicare Advantage |
$910.58
|
| Rate for Payer: Cash Price |
$2,427.20
|
| Rate for Payer: Cash Price |
$2,427.20
|
| Rate for Payer: Cofinity Commercial |
$1,311.24
|
| Rate for Payer: Cofinity Commercial |
$1,220.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.58
|
| Rate for Payer: Healthscope Commercial |
$1,092.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,092.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$956.11
|
| Rate for Payer: Meridian Medicaid |
$612.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,001.64
|
| Rate for Payer: Nomi Health Commercial |
$1,092.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,275.50
|
| Rate for Payer: PACE SWMI |
$910.58
|
| Rate for Payer: PHP Medicare Advantage |
$910.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$583.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,786.29
|
| Rate for Payer: Priority Health Medicare |
$910.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,786.29
|
| Rate for Payer: Railroad Medicare Medicare |
$910.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,737.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$910.58
|
| Rate for Payer: UHC Exchange |
$1,737.29
|
| Rate for Payer: UHC Medicaid |
$583.62
|
| Rate for Payer: UHCCP DNSP |
$910.58
|
| Rate for Payer: UHCCP Medicaid |
$583.62
|
|
|
PR ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$2,052.00
|
|
|
Service Code
|
HCPCS 44128
|
| Min. Negotiated Rate |
$139.30 |
| Max. Negotiated Rate |
$1,539.00 |
| Rate for Payer: Aetna Commercial |
$295.32
|
| Rate for Payer: Aetna Medicare |
$220.39
|
| Rate for Payer: BCBS Complete |
$146.26
|
| Rate for Payer: BCBS MAPPO |
$220.39
|
| Rate for Payer: BCN Commercial |
$361.04
|
| Rate for Payer: BCN Medicare Advantage |
$220.39
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cofinity Commercial |
$317.36
|
| Rate for Payer: Cofinity Commercial |
$295.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.39
|
| Rate for Payer: Healthscope Commercial |
$264.47
|
| Rate for Payer: Healthscope Whirlpool |
$264.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.41
|
| Rate for Payer: Meridian Medicaid |
$146.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$242.43
|
| Rate for Payer: Nomi Health Commercial |
$264.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,539.00
|
| Rate for Payer: PACE SWMI |
$220.39
|
| Rate for Payer: PHP Medicare Advantage |
$220.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$439.90
|
| Rate for Payer: Priority Health Medicare |
$220.39
|
| Rate for Payer: Priority Health Narrow Network |
$439.90
|
| Rate for Payer: Railroad Medicare Medicare |
$220.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$437.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$220.39
|
| Rate for Payer: UHC Exchange |
$437.87
|
| Rate for Payer: UHC Medicaid |
$139.30
|
| Rate for Payer: UHCCP DNSP |
$220.39
|
| Rate for Payer: UHCCP Medicaid |
$139.30
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING
|
Professional
|
Both
|
$5,178.00
|
|
|
Service Code
|
HCPCS 44127
|
| Min. Negotiated Rate |
$1,675.67 |
| Max. Negotiated Rate |
$5,196.26 |
| Rate for Payer: Aetna Commercial |
$3,526.32
|
| Rate for Payer: Aetna Medicare |
$2,631.58
|
| Rate for Payer: BCBS Complete |
$1,759.45
|
| Rate for Payer: BCBS MAPPO |
$2,631.58
|
| Rate for Payer: BCN Commercial |
$4,264.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,631.58
|
| Rate for Payer: Cash Price |
$4,142.40
|
| Rate for Payer: Cash Price |
$4,142.40
|
| Rate for Payer: Cofinity Commercial |
$3,789.48
|
| Rate for Payer: Cofinity Commercial |
$3,526.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,631.58
|
| Rate for Payer: Healthscope Commercial |
$3,157.90
|
| Rate for Payer: Healthscope Whirlpool |
$3,157.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,763.16
|
| Rate for Payer: Meridian Medicaid |
$1,759.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,894.74
|
| Rate for Payer: Nomi Health Commercial |
$3,157.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,883.50
|
| Rate for Payer: PACE SWMI |
$2,631.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,631.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,675.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,196.26
|
| Rate for Payer: Priority Health Medicare |
$2,631.58
|
| Rate for Payer: Priority Health Narrow Network |
$5,196.26
|
| Rate for Payer: Railroad Medicare Medicare |
$2,631.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,115.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,631.58
|
| Rate for Payer: UHC Exchange |
$5,115.86
|
| Rate for Payer: UHC Medicaid |
$1,675.67
|
| Rate for Payer: UHCCP DNSP |
$2,631.58
|
| Rate for Payer: UHCCP Medicaid |
$1,675.67
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING
|
Professional
|
Both
|
$4,462.00
|
|
|
Service Code
|
HCPCS 44126
|
| Min. Negotiated Rate |
$1,457.35 |
| Max. Negotiated Rate |
$4,505.18 |
| Rate for Payer: Aetna Commercial |
$3,063.01
|
| Rate for Payer: Aetna Medicare |
$2,285.83
|
| Rate for Payer: BCBS Complete |
$1,530.22
|
| Rate for Payer: BCBS MAPPO |
$2,285.83
|
| Rate for Payer: BCN Commercial |
$3,697.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,285.83
|
| Rate for Payer: Cash Price |
$3,569.60
|
| Rate for Payer: Cash Price |
$3,569.60
|
| Rate for Payer: Cofinity Commercial |
$3,291.60
|
| Rate for Payer: Cofinity Commercial |
$3,063.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,285.83
|
| Rate for Payer: Healthscope Commercial |
$2,743.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,743.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,400.12
|
| Rate for Payer: Meridian Medicaid |
$1,530.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,514.41
|
| Rate for Payer: Nomi Health Commercial |
$2,743.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,346.50
|
| Rate for Payer: PACE SWMI |
$2,285.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,285.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,457.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,505.18
|
| Rate for Payer: Priority Health Medicare |
$2,285.83
|
| Rate for Payer: Priority Health Narrow Network |
$4,505.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,285.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,421.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,285.83
|
| Rate for Payer: UHC Exchange |
$4,421.32
|
| Rate for Payer: UHC Medicaid |
$1,457.35
|
| Rate for Payer: UHCCP DNSP |
$2,285.83
|
| Rate for Payer: UHCCP Medicaid |
$1,457.35
|
|
|
PR ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST
|
Professional
|
Both
|
$3,415.00
|
|
|
Service Code
|
HCPCS 44120
|
| Min. Negotiated Rate |
$724.63 |
| Max. Negotiated Rate |
$2,561.25 |
| Rate for Payer: Aetna Commercial |
$1,518.51
|
| Rate for Payer: Aetna Medicare |
$1,133.22
|
| Rate for Payer: BCBS Complete |
$760.86
|
| Rate for Payer: BCBS MAPPO |
$1,133.22
|
| Rate for Payer: BCN Commercial |
$1,832.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,133.22
|
| Rate for Payer: Cash Price |
$2,732.00
|
| Rate for Payer: Cash Price |
$2,732.00
|
| Rate for Payer: Cofinity Commercial |
$1,631.84
|
| Rate for Payer: Cofinity Commercial |
$1,518.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,133.22
|
| Rate for Payer: Healthscope Commercial |
$1,359.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,359.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,189.88
|
| Rate for Payer: Meridian Medicaid |
$760.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,246.54
|
| Rate for Payer: Nomi Health Commercial |
$1,359.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,561.25
|
| Rate for Payer: PACE SWMI |
$1,133.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,133.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$724.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,232.87
|
| Rate for Payer: Priority Health Medicare |
$1,133.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,232.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,133.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,183.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,133.22
|
| Rate for Payer: UHC Exchange |
$2,183.58
|
| Rate for Payer: UHC Medicaid |
$724.63
|
| Rate for Payer: UHCCP DNSP |
$1,133.22
|
| Rate for Payer: UHCCP Medicaid |
$724.63
|
|
|
PR EO W/O JOINTS CF
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS L3702
|
| Min. Negotiated Rate |
$105.31 |
| Max. Negotiated Rate |
$465.08 |
| Rate for Payer: Aetna Commercial |
$432.78
|
| Rate for Payer: Aetna Medicare |
$322.97
|
| Rate for Payer: BCBS Complete |
$111.20
|
| Rate for Payer: BCBS MAPPO |
$322.97
|
| Rate for Payer: BCN Commercial |
$309.22
|
| Rate for Payer: BCN Medicare Advantage |
$322.97
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$465.08
|
| Rate for Payer: Cofinity Commercial |
$432.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.97
|
| Rate for Payer: Healthscope Commercial |
$387.56
|
| Rate for Payer: Healthscope Whirlpool |
$387.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.27
|
| Rate for Payer: Nomi Health Commercial |
$387.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.50
|
| Rate for Payer: PACE SWMI |
$322.97
|
| Rate for Payer: PHP Medicare Advantage |
$322.97
|
| Rate for Payer: Priority Health Medicare |
$322.97
|
| Rate for Payer: Railroad Medicare Medicare |
$322.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$322.97
|
| Rate for Payer: UHC Exchange |
$105.31
|
| Rate for Payer: UHCCP DNSP |
$322.97
|
|
|
PR EPDRM AGRFT T/A/L EA ADD 100 SQCM/EA 1%INFT/CHLD
|
Professional
|
Both
|
$262.00
|
|
|
Service Code
|
HCPCS 15111
|
| Min. Negotiated Rate |
$57.72 |
| Max. Negotiated Rate |
$196.50 |
| Rate for Payer: Aetna Commercial |
$121.81
|
| Rate for Payer: Aetna Medicare |
$90.90
|
| Rate for Payer: BCBS Complete |
$60.61
|
| Rate for Payer: BCBS MAPPO |
$90.90
|
| Rate for Payer: BCN Commercial |
$151.88
|
| Rate for Payer: BCN Medicare Advantage |
$90.90
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cofinity Commercial |
$130.90
|
| Rate for Payer: Cofinity Commercial |
$121.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.90
|
| Rate for Payer: Healthscope Commercial |
$109.08
|
| Rate for Payer: Healthscope Whirlpool |
$109.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.44
|
| Rate for Payer: Meridian Medicaid |
$60.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.99
|
| Rate for Payer: Nomi Health Commercial |
$109.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.50
|
| Rate for Payer: PACE SWMI |
$90.90
|
| Rate for Payer: PHP Medicare Advantage |
$90.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$139.02
|
| Rate for Payer: Priority Health Medicare |
$90.90
|
| Rate for Payer: Priority Health Narrow Network |
$139.02
|
| Rate for Payer: Railroad Medicare Medicare |
$90.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$90.90
|
| Rate for Payer: UHC Exchange |
$185.68
|
| Rate for Payer: UHC Medicaid |
$57.72
|
| Rate for Payer: UHCCP DNSP |
$90.90
|
| Rate for Payer: UHCCP Medicaid |
$57.72
|
|
|
PR EP EVAL 1/2CHMB PACG CVDFB LDS TSTG OF PULSE GEN
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 93641
|
| Min. Negotiated Rate |
$414.75 |
| Max. Negotiated Rate |
$1,037.93 |
| Rate for Payer: Aetna Commercial |
$765.30
|
| Rate for Payer: BCN Commercial |
$445.71
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$799.41
|
| Rate for Payer: Priority Health Narrow Network |
$799.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,037.93
|
| Rate for Payer: UHC Exchange |
$1,037.93
|
|
|
PR EP EVAL 1/2 CHMB TRANSVNS PAC CVDFB
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 93642
|
| Min. Negotiated Rate |
$321.18 |
| Max. Negotiated Rate |
$1,339.50 |
| Rate for Payer: Aetna Commercial |
$430.38
|
| Rate for Payer: Aetna Medicare |
$321.18
|
| Rate for Payer: BCBS MAPPO |
$321.18
|
| Rate for Payer: BCN Commercial |
$487.53
|
| Rate for Payer: BCN Medicare Advantage |
$321.18
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$430.38
|
| Rate for Payer: Cofinity Commercial |
$462.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.18
|
| Rate for Payer: Healthscope Commercial |
$385.42
|
| Rate for Payer: Healthscope Whirlpool |
$385.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$353.30
|
| Rate for Payer: Nomi Health Commercial |
$385.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PACE SWMI |
$321.18
|
| Rate for Payer: PHP Medicare Advantage |
$321.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$463.36
|
| Rate for Payer: Priority Health Medicare |
$321.18
|
| Rate for Payer: Priority Health Narrow Network |
$463.36
|
| Rate for Payer: Railroad Medicare Medicare |
$321.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$543.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$321.18
|
| Rate for Payer: UHC Exchange |
$543.39
|
| Rate for Payer: UHCCP DNSP |
$321.18
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/DGT 1ST 100 SQCM/<
|
Professional
|
Both
|
$1,512.00
|
|
|
Service Code
|
HCPCS 15115
|
| Min. Negotiated Rate |
$415.14 |
| Max. Negotiated Rate |
$1,199.52 |
| Rate for Payer: Aetna Commercial |
$857.72
|
| Rate for Payer: Aetna Medicare |
$640.09
|
| Rate for Payer: BCBS Complete |
$435.90
|
| Rate for Payer: BCBS MAPPO |
$640.09
|
| Rate for Payer: BCN Commercial |
$1,054.22
|
| Rate for Payer: BCN Medicare Advantage |
$640.09
|
| Rate for Payer: Cash Price |
$1,209.60
|
| Rate for Payer: Cash Price |
$1,209.60
|
| Rate for Payer: Cofinity Commercial |
$921.73
|
| Rate for Payer: Cofinity Commercial |
$857.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.09
|
| Rate for Payer: Healthscope Commercial |
$768.11
|
| Rate for Payer: Healthscope Whirlpool |
$768.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.09
|
| Rate for Payer: Meridian Medicaid |
$435.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$704.10
|
| Rate for Payer: Nomi Health Commercial |
$768.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,134.00
|
| Rate for Payer: PACE SWMI |
$640.09
|
| Rate for Payer: PHP Medicare Advantage |
$640.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$415.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$964.90
|
| Rate for Payer: Priority Health Medicare |
$640.09
|
| Rate for Payer: Priority Health Narrow Network |
$964.90
|
| Rate for Payer: Railroad Medicare Medicare |
$640.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,199.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$640.09
|
| Rate for Payer: UHC Exchange |
$1,199.52
|
| Rate for Payer: UHC Medicaid |
$415.14
|
| Rate for Payer: UHCCP DNSP |
$640.09
|
| Rate for Payer: UHCCP Medicaid |
$415.14
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/DGT EA 100 SQCM
|
Professional
|
Both
|
$344.00
|
|
|
Service Code
|
HCPCS 15116
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$164.89
|
| Rate for Payer: Aetna Medicare |
$123.05
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS MAPPO |
$123.05
|
| Rate for Payer: BCN Commercial |
$205.66
|
| Rate for Payer: BCN Medicare Advantage |
$123.05
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$177.19
|
| Rate for Payer: Cofinity Commercial |
$164.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.05
|
| Rate for Payer: Healthscope Commercial |
$147.66
|
| Rate for Payer: Healthscope Whirlpool |
$147.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.20
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.35
|
| Rate for Payer: Nomi Health Commercial |
$147.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.00
|
| Rate for Payer: PACE SWMI |
$123.05
|
| Rate for Payer: PHP Medicare Advantage |
$123.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$188.24
|
| Rate for Payer: Priority Health Medicare |
$123.05
|
| Rate for Payer: Priority Health Narrow Network |
$188.24
|
| Rate for Payer: Railroad Medicare Medicare |
$123.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$267.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.05
|
| Rate for Payer: UHC Exchange |
$267.91
|
| Rate for Payer: UHC Medicaid |
$78.17
|
| Rate for Payer: UHCCP DNSP |
$123.05
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
|
|
PR EPIDIDYMECTOMY BILATERAL
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 54861
|
| Min. Negotiated Rate |
$331.64 |
| Max. Negotiated Rate |
$998.85 |
| Rate for Payer: Aetna Commercial |
$684.87
|
| Rate for Payer: Aetna Medicare |
$511.10
|
| Rate for Payer: BCBS Complete |
$348.22
|
| Rate for Payer: BCBS MAPPO |
$511.10
|
| Rate for Payer: BCN Commercial |
$854.04
|
| Rate for Payer: BCN Medicare Advantage |
$511.10
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$735.98
|
| Rate for Payer: Cofinity Commercial |
$684.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.10
|
| Rate for Payer: Healthscope Commercial |
$613.32
|
| Rate for Payer: Healthscope Whirlpool |
$613.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.65
|
| Rate for Payer: Meridian Medicaid |
$348.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$562.21
|
| Rate for Payer: Nomi Health Commercial |
$613.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$828.00
|
| Rate for Payer: PACE SWMI |
$511.10
|
| Rate for Payer: PHP Medicare Advantage |
$511.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$930.32
|
| Rate for Payer: Priority Health Medicare |
$511.10
|
| Rate for Payer: Priority Health Narrow Network |
$930.32
|
| Rate for Payer: Railroad Medicare Medicare |
$511.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$998.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$511.10
|
| Rate for Payer: UHC Exchange |
$998.85
|
| Rate for Payer: UHC Medicaid |
$331.64
|
| Rate for Payer: UHCCP DNSP |
$511.10
|
| Rate for Payer: UHCCP Medicaid |
$331.64
|
|
|
PR EPIDIDYMECTOMY UNILATERAL
|
Professional
|
Both
|
$779.00
|
|
|
Service Code
|
HCPCS 54860
|
| Min. Negotiated Rate |
$247.29 |
| Max. Negotiated Rate |
$734.78 |
| Rate for Payer: Aetna Commercial |
$509.33
|
| Rate for Payer: Aetna Medicare |
$380.10
|
| Rate for Payer: BCBS Complete |
$259.65
|
| Rate for Payer: BCBS MAPPO |
$380.10
|
| Rate for Payer: BCN Commercial |
$631.94
|
| Rate for Payer: BCN Medicare Advantage |
$380.10
|
| Rate for Payer: Cash Price |
$623.20
|
| Rate for Payer: Cash Price |
$623.20
|
| Rate for Payer: Cofinity Commercial |
$547.34
|
| Rate for Payer: Cofinity Commercial |
$509.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.10
|
| Rate for Payer: Healthscope Commercial |
$456.12
|
| Rate for Payer: Healthscope Whirlpool |
$456.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.11
|
| Rate for Payer: Meridian Medicaid |
$259.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.11
|
| Rate for Payer: Nomi Health Commercial |
$456.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$584.25
|
| Rate for Payer: PACE SWMI |
$380.10
|
| Rate for Payer: PHP Medicare Advantage |
$380.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$688.39
|
| Rate for Payer: Priority Health Medicare |
$380.10
|
| Rate for Payer: Priority Health Narrow Network |
$688.39
|
| Rate for Payer: Railroad Medicare Medicare |
$380.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$734.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.10
|
| Rate for Payer: UHC Exchange |
$734.78
|
| Rate for Payer: UHC Medicaid |
$247.29
|
| Rate for Payer: UHCCP DNSP |
$380.10
|
| Rate for Payer: UHCCP Medicaid |
$247.29
|
|
|
PR EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI
|
Professional
|
Both
|
$1,774.00
|
|
|
Service Code
|
HCPCS 54900
|
| Min. Negotiated Rate |
$462.21 |
| Max. Negotiated Rate |
$1,413.40 |
| Rate for Payer: Aetna Commercial |
$957.78
|
| Rate for Payer: Aetna Medicare |
$714.76
|
| Rate for Payer: BCBS Complete |
$485.32
|
| Rate for Payer: BCBS MAPPO |
$714.76
|
| Rate for Payer: BCN Commercial |
$1,199.63
|
| Rate for Payer: BCN Medicare Advantage |
$714.76
|
| Rate for Payer: Cash Price |
$1,419.20
|
| Rate for Payer: Cash Price |
$1,419.20
|
| Rate for Payer: Cofinity Commercial |
$957.78
|
| Rate for Payer: Cofinity Commercial |
$1,029.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.76
|
| Rate for Payer: Healthscope Commercial |
$857.71
|
| Rate for Payer: Healthscope Whirlpool |
$857.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$750.50
|
| Rate for Payer: Meridian Medicaid |
$485.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$786.24
|
| Rate for Payer: Nomi Health Commercial |
$857.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,330.50
|
| Rate for Payer: PACE SWMI |
$714.76
|
| Rate for Payer: PHP Medicare Advantage |
$714.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$462.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,306.80
|
| Rate for Payer: Priority Health Medicare |
$714.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,306.80
|
| Rate for Payer: Railroad Medicare Medicare |
$714.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,413.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$714.76
|
| Rate for Payer: UHC Exchange |
$1,413.40
|
| Rate for Payer: UHC Medicaid |
$462.21
|
| Rate for Payer: UHCCP DNSP |
$714.76
|
| Rate for Payer: UHCCP Medicaid |
$462.21
|
|
|
PR EPIDRM AGRFT T/A/L 1ST 100 SQCM/</1% INFT/CHLD
|
Professional
|
Both
|
$1,656.00
|
|
|
Service Code
|
HCPCS 15110
|
| Min. Negotiated Rate |
$428.13 |
| Max. Negotiated Rate |
$1,242.00 |
| Rate for Payer: Aetna Commercial |
$884.19
|
| Rate for Payer: Aetna Medicare |
$659.84
|
| Rate for Payer: BCBS Complete |
$449.54
|
| Rate for Payer: BCBS MAPPO |
$659.84
|
| Rate for Payer: BCN Commercial |
$1,074.64
|
| Rate for Payer: BCN Medicare Advantage |
$659.84
|
| Rate for Payer: Cash Price |
$1,324.80
|
| Rate for Payer: Cash Price |
$1,324.80
|
| Rate for Payer: Cofinity Commercial |
$950.17
|
| Rate for Payer: Cofinity Commercial |
$884.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.84
|
| Rate for Payer: Healthscope Commercial |
$791.81
|
| Rate for Payer: Healthscope Whirlpool |
$791.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.83
|
| Rate for Payer: Meridian Medicaid |
$449.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$725.82
|
| Rate for Payer: Nomi Health Commercial |
$791.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,242.00
|
| Rate for Payer: PACE SWMI |
$659.84
|
| Rate for Payer: PHP Medicare Advantage |
$659.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$983.58
|
| Rate for Payer: Priority Health Medicare |
$659.84
|
| Rate for Payer: Priority Health Narrow Network |
$983.58
|
| Rate for Payer: Railroad Medicare Medicare |
$659.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,215.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$659.84
|
| Rate for Payer: UHC Exchange |
$1,215.13
|
| Rate for Payer: UHC Medicaid |
$428.13
|
| Rate for Payer: UHCCP DNSP |
$659.84
|
| Rate for Payer: UHCCP Medicaid |
$428.13
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/ULNA
|
Professional
|
Both
|
$1,298.00
|
|
|
Service Code
|
HCPCS 25450
|
| Min. Negotiated Rate |
$376.37 |
| Max. Negotiated Rate |
$1,073.70 |
| Rate for Payer: Aetna Commercial |
$768.81
|
| Rate for Payer: Aetna Medicare |
$573.74
|
| Rate for Payer: BCBS Complete |
$395.19
|
| Rate for Payer: BCBS MAPPO |
$573.74
|
| Rate for Payer: BCN Commercial |
$949.65
|
| Rate for Payer: BCN Medicare Advantage |
$573.74
|
| Rate for Payer: Cash Price |
$1,038.40
|
| Rate for Payer: Cash Price |
$1,038.40
|
| Rate for Payer: Cofinity Commercial |
$826.19
|
| Rate for Payer: Cofinity Commercial |
$768.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$573.74
|
| Rate for Payer: Healthscope Commercial |
$688.49
|
| Rate for Payer: Healthscope Whirlpool |
$688.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.43
|
| Rate for Payer: Meridian Medicaid |
$395.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$631.11
|
| Rate for Payer: Nomi Health Commercial |
$688.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$973.50
|
| Rate for Payer: PACE SWMI |
$573.74
|
| Rate for Payer: PHP Medicare Advantage |
$573.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,015.15
|
| Rate for Payer: Priority Health Medicare |
$573.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,015.15
|
| Rate for Payer: Railroad Medicare Medicare |
$573.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,073.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$573.74
|
| Rate for Payer: UHC Exchange |
$1,073.70
|
| Rate for Payer: UHC Medicaid |
$376.37
|
| Rate for Payer: UHCCP DNSP |
$573.74
|
| Rate for Payer: UHCCP Medicaid |
$376.37
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR
|
Professional
|
Both
|
$1,210.00
|
|
|
Service Code
|
HCPCS 27185
|
| Min. Negotiated Rate |
$431.75 |
| Max. Negotiated Rate |
$1,253.03 |
| Rate for Payer: Aetna Commercial |
$885.20
|
| Rate for Payer: Aetna Medicare |
$660.60
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS MAPPO |
$660.60
|
| Rate for Payer: BCN Commercial |
$1,098.55
|
| Rate for Payer: BCN Medicare Advantage |
$660.60
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cofinity Commercial |
$951.26
|
| Rate for Payer: Cofinity Commercial |
$885.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$660.60
|
| Rate for Payer: Healthscope Commercial |
$792.72
|
| Rate for Payer: Healthscope Whirlpool |
$792.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$693.63
|
| Rate for Payer: Meridian Medicaid |
$453.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$726.66
|
| Rate for Payer: Nomi Health Commercial |
$792.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.50
|
| Rate for Payer: PACE SWMI |
$660.60
|
| Rate for Payer: PHP Medicare Advantage |
$660.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,174.31
|
| Rate for Payer: Priority Health Medicare |
$660.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,174.31
|
| Rate for Payer: Railroad Medicare Medicare |
$660.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,253.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$660.60
|
| Rate for Payer: UHC Exchange |
$1,253.03
|
| Rate for Payer: UHC Medicaid |
$431.75
|
| Rate for Payer: UHCCP DNSP |
$660.60
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
|
|
PR EPISIOTOMY/VAG RPR OTH/THN ATTENDING
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 59300
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna Commercial |
$179.95
|
| Rate for Payer: Aetna Medicare |
$134.29
|
| Rate for Payer: BCBS Complete |
$89.46
|
| Rate for Payer: BCBS MAPPO |
$134.29
|
| Rate for Payer: BCN Commercial |
$221.10
|
| Rate for Payer: BCN Medicare Advantage |
$134.29
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$193.38
|
| Rate for Payer: Cofinity Commercial |
$179.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.29
|
| Rate for Payer: Healthscope Commercial |
$161.15
|
| Rate for Payer: Healthscope Whirlpool |
$161.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.00
|
| Rate for Payer: Meridian Medicaid |
$89.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.72
|
| Rate for Payer: Nomi Health Commercial |
$161.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.00
|
| Rate for Payer: PACE SWMI |
$134.29
|
| Rate for Payer: PHP Medicare Advantage |
$134.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$208.72
|
| Rate for Payer: Priority Health Medicare |
$134.29
|
| Rate for Payer: Priority Health Narrow Network |
$208.72
|
| Rate for Payer: Railroad Medicare Medicare |
$134.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$261.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.29
|
| Rate for Payer: UHC Exchange |
$261.02
|
| Rate for Payer: UHC Medicaid |
$85.20
|
| Rate for Payer: UHCCP DNSP |
$134.29
|
| Rate for Payer: UHCCP Medicaid |
$85.20
|
|
|
PR EPOETIN ALFA, NON-ESRD
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS J0885
|
| Min. Negotiated Rate |
$5.38 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$9.80
|
| Rate for Payer: Aetna Medicare |
$7.31
|
| Rate for Payer: BCBS MAPPO |
$7.31
|
| Rate for Payer: BCBS Trust/PPO |
$5.88
|
| Rate for Payer: BCN Commercial |
$5.38
|
| Rate for Payer: BCN Medicare Advantage |
$7.31
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$9.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.31
|
| Rate for Payer: Healthscope Commercial |
$8.77
|
| Rate for Payer: Healthscope Whirlpool |
$8.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.04
|
| Rate for Payer: Nomi Health Commercial |
$8.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: PACE SWMI |
$7.31
|
| Rate for Payer: PHP Medicare Advantage |
$7.31
|
| Rate for Payer: Priority Health Medicare |
$7.31
|
| Rate for Payer: Railroad Medicare Medicare |
$7.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.31
|
| Rate for Payer: UHC Exchange |
$7.74
|
| Rate for Payer: UHCCP DNSP |
$7.31
|
|
|
PR ERCP,ABLATION TUMOR
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 43272
|
| Min. Negotiated Rate |
$682.00 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: BCBS Complete |
$682.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,278.75
|
|
|
PR ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA
|
Professional
|
Both
|
$1,221.00
|
|
|
Service Code
|
HCPCS 43277
|
| Min. Negotiated Rate |
$210.44 |
| Max. Negotiated Rate |
$915.75 |
| Rate for Payer: Aetna Commercial |
$437.19
|
| Rate for Payer: Aetna Medicare |
$326.26
|
| Rate for Payer: BCBS Complete |
$220.96
|
| Rate for Payer: BCBS MAPPO |
$326.26
|
| Rate for Payer: BCN Commercial |
$555.25
|
| Rate for Payer: BCN Medicare Advantage |
$326.26
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cofinity Commercial |
$469.81
|
| Rate for Payer: Cofinity Commercial |
$437.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.26
|
| Rate for Payer: Healthscope Commercial |
$391.51
|
| Rate for Payer: Healthscope Whirlpool |
$391.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$342.57
|
| Rate for Payer: Meridian Medicaid |
$220.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$358.89
|
| Rate for Payer: Nomi Health Commercial |
$391.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.75
|
| Rate for Payer: PACE SWMI |
$326.26
|
| Rate for Payer: PHP Medicare Advantage |
$326.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$676.53
|
| Rate for Payer: Priority Health Medicare |
$326.26
|
| Rate for Payer: Priority Health Narrow Network |
$676.53
|
| Rate for Payer: Railroad Medicare Medicare |
$326.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$668.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$326.26
|
| Rate for Payer: UHC Exchange |
$668.13
|
| Rate for Payer: UHC Medicaid |
$210.44
|
| Rate for Payer: UHCCP DNSP |
$326.26
|
| Rate for Payer: UHCCP Medicaid |
$210.44
|
|
