|
PR PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS 99394
|
| Min. Negotiated Rate |
$75.52 |
| Max. Negotiated Rate |
$550.49 |
| Rate for Payer: Aetna Commercial |
$88.48
|
| Rate for Payer: BCBS Complete |
$79.30
|
| Rate for Payer: BCBS Trust/PPO |
$550.49
|
| Rate for Payer: BCN Commercial |
$120.73
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Meridian Medicaid |
$79.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.46
|
| Rate for Payer: Priority Health Narrow Network |
$107.46
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 99392
|
| Min. Negotiated Rate |
$66.69 |
| Max. Negotiated Rate |
$527.24 |
| Rate for Payer: Aetna Commercial |
$78.23
|
| Rate for Payer: BCBS Complete |
$70.02
|
| Rate for Payer: BCBS Trust/PPO |
$527.24
|
| Rate for Payer: BCN Commercial |
$151.49
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Meridian Medicaid |
$70.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.23
|
| Rate for Payer: Priority Health Narrow Network |
$149.23
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 99395
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$668.30 |
| Rate for Payer: Aetna Commercial |
$90.96
|
| Rate for Payer: BCBS Complete |
$81.54
|
| Rate for Payer: BCBS Trust/PPO |
$668.30
|
| Rate for Payer: BCN Commercial |
$123.60
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Meridian Medicaid |
$81.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.95
|
| Rate for Payer: Priority Health Narrow Network |
$110.95
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS
|
Professional
|
Both
|
$178.00
|
|
|
Service Code
|
HCPCS 99396
|
| Min. Negotiated Rate |
$85.27 |
| Max. Negotiated Rate |
$972.60 |
| Rate for Payer: Aetna Commercial |
$98.74
|
| Rate for Payer: BCBS Complete |
$89.53
|
| Rate for Payer: BCBS Trust/PPO |
$972.60
|
| Rate for Payer: BCN Commercial |
$131.12
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Meridian Medicaid |
$89.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.13
|
| Rate for Payer: Priority Health Narrow Network |
$120.13
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 99393
|
| Min. Negotiated Rate |
$66.69 |
| Max. Negotiated Rate |
$624.98 |
| Rate for Payer: Aetna Commercial |
$78.23
|
| Rate for Payer: BCBS Complete |
$70.02
|
| Rate for Payer: BCBS Trust/PPO |
$624.98
|
| Rate for Payer: BCN Commercial |
$106.47
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Meridian Medicaid |
$70.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.22
|
| Rate for Payer: Priority Health Narrow Network |
$95.22
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 99397
|
| Min. Negotiated Rate |
$89.84 |
| Max. Negotiated Rate |
$977.36 |
| Rate for Payer: Aetna Commercial |
$103.72
|
| Rate for Payer: BCBS Complete |
$94.33
|
| Rate for Payer: BCBS Trust/PPO |
$977.36
|
| Rate for Payer: BCN Commercial |
$141.51
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Meridian Medicaid |
$94.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.24
|
| Rate for Payer: Priority Health Narrow Network |
$126.24
|
|
|
PR PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 93286
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$1,612.37 |
| Rate for Payer: Aetna Commercial |
$58.45
|
| Rate for Payer: Aetna Medicare |
$43.62
|
| Rate for Payer: BCBS Complete |
$26.80
|
| Rate for Payer: BCBS MAPPO |
$43.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.37
|
| Rate for Payer: BCN Commercial |
$67.44
|
| Rate for Payer: BCN Medicare Advantage |
$43.62
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$62.81
|
| Rate for Payer: Cofinity Commercial |
$58.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.62
|
| Rate for Payer: Healthscope Commercial |
$52.34
|
| Rate for Payer: Healthscope Whirlpool |
$52.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.80
|
| Rate for Payer: PACE SWMI |
$43.62
|
| Rate for Payer: PHP Medicare Advantage |
$43.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$43.62
|
| Rate for Payer: Priority Health Narrow Network |
$65.25
|
| Rate for Payer: UHC Medicare Advantage |
$44.93
|
|
|
PR PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 93287
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$1,774.03 |
| Rate for Payer: Aetna Commercial |
$68.15
|
| Rate for Payer: Aetna Medicare |
$50.86
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS MAPPO |
$50.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,774.03
|
| Rate for Payer: BCN Commercial |
$78.19
|
| Rate for Payer: BCN Medicare Advantage |
$50.86
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$73.24
|
| Rate for Payer: Cofinity Commercial |
$68.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.86
|
| Rate for Payer: Healthscope Commercial |
$61.03
|
| Rate for Payer: Healthscope Whirlpool |
$61.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.40
|
| Rate for Payer: PACE SWMI |
$50.86
|
| Rate for Payer: PHP Medicare Advantage |
$50.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.66
|
| Rate for Payer: Priority Health Medicare |
$50.86
|
| Rate for Payer: Priority Health Narrow Network |
$75.66
|
| Rate for Payer: UHC Medicare Advantage |
$52.39
|
|
|
PR PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 45520
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$2,174.48 |
| Rate for Payer: Aetna Commercial |
$52.39
|
| Rate for Payer: Aetna Medicare |
$39.10
|
| Rate for Payer: BCBS Complete |
$27.29
|
| Rate for Payer: BCBS MAPPO |
$39.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,174.48
|
| Rate for Payer: BCN Commercial |
$240.43
|
| Rate for Payer: BCN Medicare Advantage |
$39.10
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cofinity Commercial |
$52.39
|
| Rate for Payer: Cofinity Commercial |
$56.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.10
|
| Rate for Payer: Healthscope Commercial |
$46.92
|
| Rate for Payer: Healthscope Whirlpool |
$46.92
|
| Rate for Payer: Meridian Medicaid |
$27.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.06
|
| Rate for Payer: PACE SWMI |
$39.10
|
| Rate for Payer: PHP Medicare Advantage |
$39.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.55
|
| Rate for Payer: Priority Health Medicare |
$39.10
|
| Rate for Payer: Priority Health Narrow Network |
$70.55
|
| Rate for Payer: UHC Medicare Advantage |
$40.27
|
|
|
PR PERITONEAL LAVAGE W/WO IMAGING GUIDANCE
|
Professional
|
Both
|
$134.00
|
|
|
Service Code
|
HCPCS 49084
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$530.41 |
| Rate for Payer: Aetna Commercial |
$142.92
|
| Rate for Payer: Aetna Medicare |
$106.66
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS MAPPO |
$106.66
|
| Rate for Payer: BCBS Trust/PPO |
$530.41
|
| Rate for Payer: BCN Commercial |
$155.40
|
| Rate for Payer: BCN Medicare Advantage |
$106.66
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Cofinity Commercial |
$153.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.66
|
| Rate for Payer: Healthscope Commercial |
$127.99
|
| Rate for Payer: Healthscope Whirlpool |
$127.99
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.99
|
| Rate for Payer: PACE SWMI |
$106.66
|
| Rate for Payer: PHP Medicare Advantage |
$106.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.97
|
| Rate for Payer: Priority Health Medicare |
$106.66
|
| Rate for Payer: Priority Health Narrow Network |
$186.97
|
| Rate for Payer: UHC Medicare Advantage |
$109.86
|
|
|
PR PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT
|
Professional
|
Both
|
$262.00
|
|
|
Service Code
|
HCPCS 34713
|
| Min. Negotiated Rate |
$76.47 |
| Max. Negotiated Rate |
$1,464.98 |
| Rate for Payer: Aetna Commercial |
$163.04
|
| Rate for Payer: Aetna Medicare |
$121.67
|
| Rate for Payer: BCBS Complete |
$80.29
|
| Rate for Payer: BCBS MAPPO |
$121.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,464.98
|
| Rate for Payer: BCN Commercial |
$175.44
|
| Rate for Payer: BCN Medicare Advantage |
$121.67
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cofinity Commercial |
$175.20
|
| Rate for Payer: Cofinity Commercial |
$163.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.67
|
| Rate for Payer: Healthscope Commercial |
$146.00
|
| Rate for Payer: Healthscope Whirlpool |
$146.00
|
| Rate for Payer: Meridian Medicaid |
$80.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$127.75
|
| Rate for Payer: PACE SWMI |
$121.67
|
| Rate for Payer: PHP Medicare Advantage |
$121.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.98
|
| Rate for Payer: Priority Health Medicare |
$121.67
|
| Rate for Payer: Priority Health Narrow Network |
$190.98
|
| Rate for Payer: UHC Medicare Advantage |
$125.32
|
|
|
PR PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL
|
Professional
|
Both
|
$1,583.00
|
|
|
Service Code
|
HCPCS 61645
|
| Min. Negotiated Rate |
$117.81 |
| Max. Negotiated Rate |
$1,416.13 |
| Rate for Payer: Aetna Commercial |
$1,125.18
|
| Rate for Payer: Aetna Medicare |
$839.69
|
| Rate for Payer: BCBS Complete |
$562.93
|
| Rate for Payer: BCBS MAPPO |
$839.69
|
| Rate for Payer: BCBS Trust/PPO |
$117.81
|
| Rate for Payer: BCN Commercial |
$1,222.18
|
| Rate for Payer: BCN Medicare Advantage |
$839.69
|
| Rate for Payer: Cash Price |
$1,266.40
|
| Rate for Payer: Cash Price |
$1,266.40
|
| Rate for Payer: Cofinity Commercial |
$1,209.15
|
| Rate for Payer: Cofinity Commercial |
$1,125.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$839.69
|
| Rate for Payer: Healthscope Commercial |
$1,007.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,007.63
|
| Rate for Payer: Meridian Medicaid |
$562.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$881.67
|
| Rate for Payer: PACE SWMI |
$839.69
|
| Rate for Payer: PHP Medicare Advantage |
$839.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,108.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,416.13
|
| Rate for Payer: Priority Health Medicare |
$839.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,416.13
|
| Rate for Payer: UHC Medicare Advantage |
$864.88
|
|
|
PR PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER
|
Professional
|
Both
|
$679.00
|
|
|
Service Code
|
HCPCS 61642
|
| Min. Negotiated Rate |
$109.36 |
| Max. Negotiated Rate |
$557.16 |
| Rate for Payer: Aetna Commercial |
$445.23
|
| Rate for Payer: BCBS Complete |
$271.60
|
| Rate for Payer: BCBS Trust/PPO |
$109.36
|
| Rate for Payer: BCN Commercial |
$480.86
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.16
|
| Rate for Payer: Priority Health Narrow Network |
$557.16
|
|
|
PR PERQ BALO DILA IC VSPSM EA VSL SM VASC TER
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 61641
|
| Min. Negotiated Rate |
$105.66 |
| Max. Negotiated Rate |
$278.59 |
| Rate for Payer: Aetna Commercial |
$222.61
|
| Rate for Payer: BCBS Complete |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$105.66
|
| Rate for Payer: BCN Commercial |
$240.43
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.59
|
| Rate for Payer: Priority Health Narrow Network |
$278.59
|
|
|
PR PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 19285
|
| Min. Negotiated Rate |
$52.61 |
| Max. Negotiated Rate |
$2,904.75 |
| Rate for Payer: Aetna Commercial |
$111.64
|
| Rate for Payer: Aetna Medicare |
$83.31
|
| Rate for Payer: BCBS Complete |
$55.24
|
| Rate for Payer: BCBS MAPPO |
$83.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,904.75
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: BCN Medicare Advantage |
$83.31
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$111.64
|
| Rate for Payer: Cofinity Commercial |
$119.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.31
|
| Rate for Payer: Healthscope Commercial |
$99.97
|
| Rate for Payer: Healthscope Whirlpool |
$99.97
|
| Rate for Payer: Meridian Medicaid |
$55.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.48
|
| Rate for Payer: PACE SWMI |
$83.31
|
| Rate for Payer: PHP Medicare Advantage |
$83.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.76
|
| Rate for Payer: Priority Health Medicare |
$83.31
|
| Rate for Payer: Priority Health Narrow Network |
$102.76
|
| Rate for Payer: UHC Medicare Advantage |
$85.81
|
|
|
PR PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 19286
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$56.31
|
| Rate for Payer: Aetna Medicare |
$42.02
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$42.02
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$450.56
|
| Rate for Payer: BCN Medicare Advantage |
$42.02
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$60.51
|
| Rate for Payer: Cofinity Commercial |
$56.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.02
|
| Rate for Payer: Healthscope Commercial |
$50.42
|
| Rate for Payer: Healthscope Whirlpool |
$50.42
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.12
|
| Rate for Payer: PACE SWMI |
$42.02
|
| Rate for Payer: PHP Medicare Advantage |
$42.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.79
|
| Rate for Payer: Priority Health Medicare |
$42.02
|
| Rate for Payer: Priority Health Narrow Network |
$51.79
|
| Rate for Payer: UHC Medicare Advantage |
$43.28
|
|
|
PR PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT
|
Professional
|
Both
|
$1,630.00
|
|
|
Service Code
|
HCPCS 33340
|
| Min. Negotiated Rate |
$486.49 |
| Max. Negotiated Rate |
$1,221.37 |
| Rate for Payer: Aetna Commercial |
$1,029.68
|
| Rate for Payer: Aetna Medicare |
$768.42
|
| Rate for Payer: BCBS Complete |
$510.81
|
| Rate for Payer: BCBS MAPPO |
$768.42
|
| Rate for Payer: BCBS Trust/PPO |
$775.02
|
| Rate for Payer: BCN Commercial |
$1,122.01
|
| Rate for Payer: BCN Medicare Advantage |
$768.42
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Cofinity Commercial |
$1,106.52
|
| Rate for Payer: Cofinity Commercial |
$1,029.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$768.42
|
| Rate for Payer: Healthscope Commercial |
$922.10
|
| Rate for Payer: Healthscope Whirlpool |
$922.10
|
| Rate for Payer: Meridian Medicaid |
$510.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$806.84
|
| Rate for Payer: PACE SWMI |
$768.42
|
| Rate for Payer: PHP Medicare Advantage |
$768.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,221.37
|
| Rate for Payer: Priority Health Medicare |
$768.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,221.37
|
| Rate for Payer: UHC Medicare Advantage |
$791.47
|
|
|
PR PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 19281
|
| Min. Negotiated Rate |
$61.56 |
| Max. Negotiated Rate |
$354.78 |
| Rate for Payer: Aetna Commercial |
$129.81
|
| Rate for Payer: Aetna Medicare |
$96.87
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCBS MAPPO |
$96.87
|
| Rate for Payer: BCBS Trust/PPO |
$100.60
|
| Rate for Payer: BCN Commercial |
$354.78
|
| Rate for Payer: BCN Medicare Advantage |
$96.87
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$129.81
|
| Rate for Payer: Cofinity Commercial |
$139.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.87
|
| Rate for Payer: Healthscope Commercial |
$116.24
|
| Rate for Payer: Healthscope Whirlpool |
$116.24
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$101.71
|
| Rate for Payer: PACE SWMI |
$96.87
|
| Rate for Payer: PHP Medicare Advantage |
$96.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.61
|
| Rate for Payer: Priority Health Medicare |
$96.87
|
| Rate for Payer: Priority Health Narrow Network |
$119.61
|
| Rate for Payer: UHC Medicare Advantage |
$99.78
|
|
|
PR PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 19282
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$2,700.00 |
| Rate for Payer: Aetna Commercial |
$65.61
|
| Rate for Payer: Aetna Medicare |
$48.96
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$48.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,700.00
|
| Rate for Payer: BCN Commercial |
$252.16
|
| Rate for Payer: BCN Medicare Advantage |
$48.96
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cofinity Commercial |
$65.61
|
| Rate for Payer: Cofinity Commercial |
$70.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$58.75
|
| Rate for Payer: Healthscope Whirlpool |
$58.75
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.41
|
| Rate for Payer: PACE SWMI |
$48.96
|
| Rate for Payer: PHP Medicare Advantage |
$48.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.42
|
| Rate for Payer: Priority Health Medicare |
$48.96
|
| Rate for Payer: Priority Health Narrow Network |
$60.42
|
| Rate for Payer: UHC Medicare Advantage |
$50.43
|
|
|
PR PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 50436
|
| Min. Negotiated Rate |
$93.29 |
| Max. Negotiated Rate |
$1,729.65 |
| Rate for Payer: Aetna Commercial |
$193.76
|
| Rate for Payer: Aetna Medicare |
$144.60
|
| Rate for Payer: BCBS Complete |
$97.95
|
| Rate for Payer: BCBS MAPPO |
$144.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,729.65
|
| Rate for Payer: BCN Commercial |
$213.06
|
| Rate for Payer: BCN Medicare Advantage |
$144.60
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$208.22
|
| Rate for Payer: Cofinity Commercial |
$193.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.60
|
| Rate for Payer: Healthscope Commercial |
$173.52
|
| Rate for Payer: Healthscope Whirlpool |
$173.52
|
| Rate for Payer: Meridian Medicaid |
$97.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$151.83
|
| Rate for Payer: PACE SWMI |
$144.60
|
| Rate for Payer: PHP Medicare Advantage |
$144.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.60
|
| Rate for Payer: Priority Health Medicare |
$144.60
|
| Rate for Payer: Priority Health Narrow Network |
$235.60
|
| Rate for Payer: UHC Medicare Advantage |
$148.94
|
|
|
PR PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING
|
Professional
|
Both
|
$965.00
|
|
|
Service Code
|
HCPCS 32557
|
| Min. Negotiated Rate |
$93.08 |
| Max. Negotiated Rate |
$980.78 |
| Rate for Payer: Aetna Commercial |
$196.04
|
| Rate for Payer: Aetna Medicare |
$146.30
|
| Rate for Payer: BCBS Complete |
$97.73
|
| Rate for Payer: BCBS MAPPO |
$146.30
|
| Rate for Payer: BCBS Trust/PPO |
$656.15
|
| Rate for Payer: BCN Commercial |
$980.78
|
| Rate for Payer: BCN Medicare Advantage |
$146.30
|
| Rate for Payer: Cash Price |
$772.00
|
| Rate for Payer: Cash Price |
$772.00
|
| Rate for Payer: Cofinity Commercial |
$210.67
|
| Rate for Payer: Cofinity Commercial |
$196.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.30
|
| Rate for Payer: Healthscope Commercial |
$175.56
|
| Rate for Payer: Healthscope Whirlpool |
$175.56
|
| Rate for Payer: Meridian Medicaid |
$97.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$153.62
|
| Rate for Payer: PACE SWMI |
$146.30
|
| Rate for Payer: PHP Medicare Advantage |
$146.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.82
|
| Rate for Payer: Priority Health Medicare |
$146.30
|
| Rate for Payer: Priority Health Narrow Network |
$202.82
|
| Rate for Payer: UHC Medicare Advantage |
$150.69
|
|
|
PR PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 32556
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$1,091.21 |
| Rate for Payer: Aetna Commercial |
$163.72
|
| Rate for Payer: Aetna Medicare |
$122.18
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCBS MAPPO |
$122.18
|
| Rate for Payer: BCBS Trust/PPO |
$507.70
|
| Rate for Payer: BCN Commercial |
$1,091.21
|
| Rate for Payer: BCN Medicare Advantage |
$122.18
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$175.94
|
| Rate for Payer: Cofinity Commercial |
$163.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.18
|
| Rate for Payer: Healthscope Commercial |
$146.62
|
| Rate for Payer: Healthscope Whirlpool |
$146.62
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.29
|
| Rate for Payer: PACE SWMI |
$122.18
|
| Rate for Payer: PHP Medicare Advantage |
$122.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.01
|
| Rate for Payer: Priority Health Medicare |
$122.18
|
| Rate for Payer: Priority Health Narrow Network |
$169.01
|
| Rate for Payer: UHC Medicare Advantage |
$125.85
|
|
|
PR PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS
|
Professional
|
Both
|
$2,400.00
|
|
|
Service Code
|
HCPCS 50081
|
| Min. Negotiated Rate |
$712.27 |
| Max. Negotiated Rate |
$2,246.86 |
| Rate for Payer: Aetna Commercial |
$1,472.77
|
| Rate for Payer: Aetna Medicare |
$1,099.08
|
| Rate for Payer: BCBS Complete |
$747.88
|
| Rate for Payer: BCBS MAPPO |
$1,099.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,246.86
|
| Rate for Payer: BCN Commercial |
$1,618.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.08
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cofinity Commercial |
$1,582.68
|
| Rate for Payer: Cofinity Commercial |
$1,472.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.08
|
| Rate for Payer: Healthscope Commercial |
$1,318.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,318.90
|
| Rate for Payer: Meridian Medicaid |
$747.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,154.03
|
| Rate for Payer: PACE SWMI |
$1,099.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$712.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,680.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,789.13
|
| Rate for Payer: Priority Health Medicare |
$1,099.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,789.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,132.05
|
|
|
PR PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION
|
Professional
|
Both
|
$1,631.00
|
|
|
Service Code
|
HCPCS 50080
|
| Min. Negotiated Rate |
$442.83 |
| Max. Negotiated Rate |
$1,141.70 |
| Rate for Payer: Aetna Commercial |
$911.41
|
| Rate for Payer: Aetna Medicare |
$680.16
|
| Rate for Payer: BCBS Complete |
$464.97
|
| Rate for Payer: BCBS MAPPO |
$680.16
|
| Rate for Payer: BCBS Trust/PPO |
$652.45
|
| Rate for Payer: BCN Commercial |
$1,004.24
|
| Rate for Payer: BCN Medicare Advantage |
$680.16
|
| Rate for Payer: Cash Price |
$1,304.80
|
| Rate for Payer: Cash Price |
$1,304.80
|
| Rate for Payer: Cofinity Commercial |
$979.43
|
| Rate for Payer: Cofinity Commercial |
$911.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.16
|
| Rate for Payer: Healthscope Commercial |
$816.19
|
| Rate for Payer: Healthscope Whirlpool |
$816.19
|
| Rate for Payer: Meridian Medicaid |
$464.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$714.17
|
| Rate for Payer: PACE SWMI |
$680.16
|
| Rate for Payer: PHP Medicare Advantage |
$680.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,110.43
|
| Rate for Payer: Priority Health Medicare |
$680.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,110.43
|
| Rate for Payer: UHC Medicare Advantage |
$700.56
|
|
|
PR PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Professional
|
Both
|
$498.00
|
|
|
Service Code
|
HCPCS 33017
|
| Min. Negotiated Rate |
$154.43 |
| Max. Negotiated Rate |
$750.19 |
| Rate for Payer: Aetna Commercial |
$323.86
|
| Rate for Payer: Aetna Medicare |
$241.69
|
| Rate for Payer: BCBS Complete |
$162.15
|
| Rate for Payer: BCBS MAPPO |
$241.69
|
| Rate for Payer: BCBS Trust/PPO |
$750.19
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$241.69
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cofinity Commercial |
$323.86
|
| Rate for Payer: Cofinity Commercial |
$348.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.69
|
| Rate for Payer: Healthscope Commercial |
$290.03
|
| Rate for Payer: Healthscope Whirlpool |
$290.03
|
| Rate for Payer: Meridian Medicaid |
$162.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$253.77
|
| Rate for Payer: PACE SWMI |
$241.69
|
| Rate for Payer: PHP Medicare Advantage |
$241.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$383.01
|
| Rate for Payer: Priority Health Medicare |
$241.69
|
| Rate for Payer: Priority Health Narrow Network |
$383.01
|
| Rate for Payer: UHC Medicare Advantage |
$248.94
|
|
