|
PR PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 99412
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$1,314.41 |
| Rate for Payer: Aetna Commercial |
$13.09
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.41
|
| Rate for Payer: BCN Commercial |
$36.65
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.85
|
| Rate for Payer: Priority Health Narrow Network |
$15.85
|
|
|
PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP
|
Professional
|
Both
|
$165.00
|
|
|
Service Code
|
HCPCS 93279
|
| Min. Negotiated Rate |
$64.80 |
| Max. Negotiated Rate |
$530.41 |
| Rate for Payer: Aetna Commercial |
$86.83
|
| Rate for Payer: Aetna Medicare |
$64.80
|
| Rate for Payer: BCBS Complete |
$66.00
|
| Rate for Payer: BCBS MAPPO |
$64.80
|
| Rate for Payer: BCBS Trust/PPO |
$530.41
|
| Rate for Payer: BCN Commercial |
$99.20
|
| Rate for Payer: BCN Medicare Advantage |
$64.80
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cofinity Commercial |
$93.31
|
| Rate for Payer: Cofinity Commercial |
$86.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.80
|
| Rate for Payer: Healthscope Commercial |
$77.76
|
| Rate for Payer: Healthscope Whirlpool |
$77.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68.04
|
| Rate for Payer: PACE SWMI |
$64.80
|
| Rate for Payer: PHP Medicare Advantage |
$64.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.99
|
| Rate for Payer: Priority Health Medicare |
$64.80
|
| Rate for Payer: Priority Health Narrow Network |
$95.99
|
| Rate for Payer: UHC Medicare Advantage |
$66.74
|
|
|
PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 93285
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$1,404.75 |
| Rate for Payer: Aetna Commercial |
$77.61
|
| Rate for Payer: Aetna Commercial |
$77.61
|
| Rate for Payer: Aetna Medicare |
$57.92
|
| Rate for Payer: Aetna Medicare |
$57.92
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS Complete |
$48.00
|
| Rate for Payer: BCBS MAPPO |
$57.92
|
| Rate for Payer: BCBS MAPPO |
$57.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,404.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,404.75
|
| Rate for Payer: BCN Commercial |
$88.94
|
| Rate for Payer: BCN Commercial |
$88.94
|
| Rate for Payer: BCN Medicare Advantage |
$57.92
|
| Rate for Payer: BCN Medicare Advantage |
$57.92
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$83.40
|
| Rate for Payer: Cofinity Commercial |
$83.40
|
| Rate for Payer: Cofinity Commercial |
$77.61
|
| Rate for Payer: Cofinity Commercial |
$77.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.92
|
| Rate for Payer: Healthscope Commercial |
$69.50
|
| Rate for Payer: Healthscope Commercial |
$69.50
|
| Rate for Payer: Healthscope Whirlpool |
$69.50
|
| Rate for Payer: Healthscope Whirlpool |
$69.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.82
|
| Rate for Payer: PACE SWMI |
$57.92
|
| Rate for Payer: PACE SWMI |
$57.92
|
| Rate for Payer: PHP Medicare Advantage |
$57.92
|
| Rate for Payer: PHP Medicare Advantage |
$57.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.06
|
| Rate for Payer: Priority Health Medicare |
$57.92
|
| Rate for Payer: Priority Health Medicare |
$57.92
|
| Rate for Payer: Priority Health Narrow Network |
$86.06
|
| Rate for Payer: Priority Health Narrow Network |
$86.06
|
| Rate for Payer: UHC Medicare Advantage |
$59.66
|
| Rate for Payer: UHC Medicare Advantage |
$59.66
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 93284
|
| Min. Negotiated Rate |
$66.80 |
| Max. Negotiated Rate |
$1,468.15 |
| Rate for Payer: Aetna Commercial |
$136.97
|
| Rate for Payer: Aetna Medicare |
$102.22
|
| Rate for Payer: BCBS Complete |
$66.80
|
| Rate for Payer: BCBS MAPPO |
$102.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,468.15
|
| Rate for Payer: BCN Commercial |
$155.40
|
| Rate for Payer: BCN Medicare Advantage |
$102.22
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$136.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.22
|
| Rate for Payer: Healthscope Commercial |
$122.66
|
| Rate for Payer: Healthscope Whirlpool |
$122.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.33
|
| Rate for Payer: PACE SWMI |
$102.22
|
| Rate for Payer: PHP Medicare Advantage |
$102.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.37
|
| Rate for Payer: Priority Health Medicare |
$102.22
|
| Rate for Payer: Priority Health Narrow Network |
$150.37
|
| Rate for Payer: UHC Medicare Advantage |
$105.29
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 93283
|
| Min. Negotiated Rate |
$62.00 |
| Max. Negotiated Rate |
$214.49 |
| Rate for Payer: Aetna Commercial |
$127.06
|
| Rate for Payer: Aetna Medicare |
$94.82
|
| Rate for Payer: BCBS Complete |
$62.00
|
| Rate for Payer: BCBS MAPPO |
$94.82
|
| Rate for Payer: BCBS Trust/PPO |
$214.49
|
| Rate for Payer: BCN Commercial |
$144.16
|
| Rate for Payer: BCN Medicare Advantage |
$94.82
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$136.54
|
| Rate for Payer: Cofinity Commercial |
$127.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.82
|
| Rate for Payer: Healthscope Commercial |
$113.78
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99.56
|
| Rate for Payer: PACE SWMI |
$94.82
|
| Rate for Payer: PHP Medicare Advantage |
$94.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.50
|
| Rate for Payer: Priority Health Medicare |
$94.82
|
| Rate for Payer: Priority Health Narrow Network |
$139.50
|
| Rate for Payer: UHC Medicare Advantage |
$97.66
|
|
|
PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 93282
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$1,583.32 |
| Rate for Payer: Aetna Commercial |
$103.92
|
| Rate for Payer: Aetna Medicare |
$77.55
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$77.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,583.32
|
| Rate for Payer: BCN Commercial |
$118.26
|
| Rate for Payer: BCN Medicare Advantage |
$77.55
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$103.92
|
| Rate for Payer: Cofinity Commercial |
$111.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.55
|
| Rate for Payer: Healthscope Commercial |
$93.06
|
| Rate for Payer: Healthscope Whirlpool |
$93.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$81.43
|
| Rate for Payer: PACE SWMI |
$77.55
|
| Rate for Payer: PHP Medicare Advantage |
$77.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.44
|
| Rate for Payer: Priority Health Medicare |
$77.55
|
| Rate for Payer: Priority Health Narrow Network |
$114.44
|
| Rate for Payer: UHC Medicare Advantage |
$79.88
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS
|
Professional
|
Both
|
$5,614.00
|
|
|
Service Code
|
HCPCS 33031
|
| Min. Negotiated Rate |
$1,051.32 |
| Max. Negotiated Rate |
$3,929.80 |
| Rate for Payer: Aetna Commercial |
$3,259.98
|
| Rate for Payer: Aetna Medicare |
$2,432.82
|
| Rate for Payer: BCBS Complete |
$1,627.06
|
| Rate for Payer: BCBS MAPPO |
$2,432.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,051.32
|
| Rate for Payer: BCN Commercial |
$3,542.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,432.82
|
| Rate for Payer: Cash Price |
$4,491.20
|
| Rate for Payer: Cash Price |
$4,491.20
|
| Rate for Payer: Cofinity Commercial |
$3,503.26
|
| Rate for Payer: Cofinity Commercial |
$3,259.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,432.82
|
| Rate for Payer: Healthscope Commercial |
$2,919.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,919.38
|
| Rate for Payer: Meridian Medicaid |
$1,627.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,554.46
|
| Rate for Payer: PACE SWMI |
$2,432.82
|
| Rate for Payer: PHP Medicare Advantage |
$2,432.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,929.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,856.69
|
| Rate for Payer: Priority Health Medicare |
$2,432.82
|
| Rate for Payer: Priority Health Narrow Network |
$3,856.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,505.80
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS
|
Professional
|
Both
|
$3,352.00
|
|
|
Service Code
|
HCPCS 33030
|
| Min. Negotiated Rate |
$1,062.94 |
| Max. Negotiated Rate |
$3,118.87 |
| Rate for Payer: Aetna Commercial |
$2,634.02
|
| Rate for Payer: Aetna Medicare |
$1,965.69
|
| Rate for Payer: BCBS Complete |
$1,317.75
|
| Rate for Payer: BCBS MAPPO |
$1,965.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.94
|
| Rate for Payer: BCN Commercial |
$2,865.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,965.69
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cofinity Commercial |
$2,634.02
|
| Rate for Payer: Cofinity Commercial |
$2,830.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,965.69
|
| Rate for Payer: Healthscope Commercial |
$2,358.83
|
| Rate for Payer: Healthscope Whirlpool |
$2,358.83
|
| Rate for Payer: Meridian Medicaid |
$1,317.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,063.97
|
| Rate for Payer: PACE SWMI |
$1,965.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,965.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,255.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,346.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,118.87
|
| Rate for Payer: Priority Health Medicare |
$1,965.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,118.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,024.66
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST
|
Professional
|
Both
|
$4,051.74
|
|
|
Service Code
|
HCPCS 37184
|
| Min. Negotiated Rate |
$267.32 |
| Max. Negotiated Rate |
$2,836.22 |
| Rate for Payer: Aetna Commercial |
$565.06
|
| Rate for Payer: Aetna Medicare |
$421.69
|
| Rate for Payer: BCBS Complete |
$280.69
|
| Rate for Payer: BCBS MAPPO |
$421.69
|
| Rate for Payer: BCBS Trust/PPO |
$939.85
|
| Rate for Payer: BCN Commercial |
$2,516.69
|
| Rate for Payer: BCN Medicare Advantage |
$421.69
|
| Rate for Payer: Cash Price |
$3,241.39
|
| Rate for Payer: Cash Price |
$3,241.39
|
| Rate for Payer: Cofinity Commercial |
$565.06
|
| Rate for Payer: Cofinity Commercial |
$607.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.69
|
| Rate for Payer: Healthscope Commercial |
$506.03
|
| Rate for Payer: Healthscope Whirlpool |
$506.03
|
| Rate for Payer: Meridian Medicaid |
$280.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$442.77
|
| Rate for Payer: PACE SWMI |
$421.69
|
| Rate for Payer: PHP Medicare Advantage |
$421.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,836.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$667.60
|
| Rate for Payer: Priority Health Medicare |
$421.69
|
| Rate for Payer: Priority Health Narrow Network |
$667.60
|
| Rate for Payer: UHC Medicare Advantage |
$434.34
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ
|
Professional
|
Both
|
$3,373.00
|
|
|
Service Code
|
HCPCS 37185
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$2,361.10 |
| Rate for Payer: Aetna Commercial |
$214.63
|
| Rate for Payer: Aetna Medicare |
$160.17
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS MAPPO |
$160.17
|
| Rate for Payer: BCBS Trust/PPO |
$728.00
|
| Rate for Payer: BCN Commercial |
$693.44
|
| Rate for Payer: BCN Medicare Advantage |
$160.17
|
| Rate for Payer: Cash Price |
$2,698.40
|
| Rate for Payer: Cash Price |
$2,698.40
|
| Rate for Payer: Cofinity Commercial |
$214.63
|
| Rate for Payer: Cofinity Commercial |
$230.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.17
|
| Rate for Payer: Healthscope Commercial |
$192.20
|
| Rate for Payer: Healthscope Whirlpool |
$192.20
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$168.18
|
| Rate for Payer: PACE SWMI |
$160.17
|
| Rate for Payer: PHP Medicare Advantage |
$160.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,361.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.67
|
| Rate for Payer: Priority Health Medicare |
$160.17
|
| Rate for Payer: Priority Health Narrow Network |
$252.67
|
| Rate for Payer: UHC Medicare Advantage |
$164.98
|
|
|
PR PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS 99424
|
| Min. Negotiated Rate |
$47.07 |
| Max. Negotiated Rate |
$1,314.94 |
| Rate for Payer: Aetna Commercial |
$96.37
|
| Rate for Payer: Aetna Medicare |
$71.92
|
| Rate for Payer: BCBS Complete |
$49.42
|
| Rate for Payer: BCBS MAPPO |
$71.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.94
|
| Rate for Payer: BCN Commercial |
$117.28
|
| Rate for Payer: BCN Medicare Advantage |
$71.92
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$96.37
|
| Rate for Payer: Cofinity Commercial |
$103.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.92
|
| Rate for Payer: Healthscope Commercial |
$79.11
|
| Rate for Payer: Healthscope Whirlpool |
$79.11
|
| Rate for Payer: Meridian Medicaid |
$49.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.52
|
| Rate for Payer: PACE SWMI |
$71.92
|
| Rate for Payer: PHP Medicare Advantage |
$71.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.52
|
| Rate for Payer: Priority Health Medicare |
$71.92
|
| Rate for Payer: Priority Health Narrow Network |
$75.52
|
| Rate for Payer: UHC Medicare Advantage |
$74.08
|
|
|
PR PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 99426
|
| Min. Negotiated Rate |
$31.31 |
| Max. Negotiated Rate |
$1,519.92 |
| Rate for Payer: Aetna Commercial |
$64.63
|
| Rate for Payer: Aetna Medicare |
$48.23
|
| Rate for Payer: BCBS Complete |
$32.88
|
| Rate for Payer: BCBS MAPPO |
$48.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,519.92
|
| Rate for Payer: BCN Commercial |
$88.45
|
| Rate for Payer: BCN Medicare Advantage |
$48.23
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$69.45
|
| Rate for Payer: Cofinity Commercial |
$64.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.23
|
| Rate for Payer: Healthscope Commercial |
$53.05
|
| Rate for Payer: Healthscope Whirlpool |
$53.05
|
| Rate for Payer: Meridian Medicaid |
$32.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.64
|
| Rate for Payer: PACE SWMI |
$48.23
|
| Rate for Payer: PHP Medicare Advantage |
$48.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.46
|
| Rate for Payer: Priority Health Medicare |
$48.23
|
| Rate for Payer: Priority Health Narrow Network |
$50.46
|
| Rate for Payer: UHC Medicare Advantage |
$49.68
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 99427
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$971.54 |
| Rate for Payer: Aetna Commercial |
$45.92
|
| Rate for Payer: Aetna Medicare |
$34.27
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCBS MAPPO |
$34.27
|
| Rate for Payer: BCBS Trust/PPO |
$971.54
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: BCN Medicare Advantage |
$34.27
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$49.35
|
| Rate for Payer: Cofinity Commercial |
$45.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$37.70
|
| Rate for Payer: Healthscope Whirlpool |
$37.70
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.98
|
| Rate for Payer: PACE SWMI |
$34.27
|
| Rate for Payer: PHP Medicare Advantage |
$34.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.84
|
| Rate for Payer: Priority Health Medicare |
$34.27
|
| Rate for Payer: Priority Health Narrow Network |
$35.84
|
| Rate for Payer: UHC Medicare Advantage |
$35.30
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 99425
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$1,104.48 |
| Rate for Payer: Aetna Commercial |
$66.61
|
| Rate for Payer: Aetna Medicare |
$49.71
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS MAPPO |
$49.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.48
|
| Rate for Payer: BCN Commercial |
$84.05
|
| Rate for Payer: BCN Medicare Advantage |
$49.71
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$66.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.71
|
| Rate for Payer: Healthscope Commercial |
$54.68
|
| Rate for Payer: Healthscope Whirlpool |
$54.68
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.20
|
| Rate for Payer: PACE SWMI |
$49.71
|
| Rate for Payer: PHP Medicare Advantage |
$49.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.20
|
| Rate for Payer: Priority Health Medicare |
$49.71
|
| Rate for Payer: Priority Health Narrow Network |
$52.20
|
| Rate for Payer: UHC Medicare Advantage |
$51.20
|
|
|
PR PROBE NASOLACRIMAL DUCT W/WO IRRIGATION
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 68810
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$4,968.66 |
| Rate for Payer: Aetna Commercial |
$163.08
|
| Rate for Payer: Aetna Medicare |
$121.70
|
| Rate for Payer: BCBS Complete |
$85.21
|
| Rate for Payer: BCBS MAPPO |
$121.70
|
| Rate for Payer: BCBS Trust/PPO |
$4,968.66
|
| Rate for Payer: BCN Commercial |
$188.09
|
| Rate for Payer: BCN Medicare Advantage |
$121.70
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$163.08
|
| Rate for Payer: Cofinity Commercial |
$175.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.70
|
| Rate for Payer: Healthscope Commercial |
$146.04
|
| Rate for Payer: Healthscope Whirlpool |
$146.04
|
| Rate for Payer: Meridian Medicaid |
$85.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$127.78
|
| Rate for Payer: PACE SWMI |
$121.70
|
| Rate for Payer: PHP Medicare Advantage |
$121.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.70
|
| Rate for Payer: Priority Health Medicare |
$121.70
|
| Rate for Payer: Priority Health Narrow Network |
$220.70
|
| Rate for Payer: UHC Medicare Advantage |
$125.35
|
|
|
PR PROCHLORPERAZINE INJECTION
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS J0780
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Aetna Commercial |
$4.04
|
| Rate for Payer: Aetna Medicare |
$3.01
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$3.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.73
|
| Rate for Payer: BCN Commercial |
$1.74
|
| Rate for Payer: BCN Medicare Advantage |
$3.01
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$4.04
|
| Rate for Payer: Cofinity Commercial |
$4.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.01
|
| Rate for Payer: Healthscope Commercial |
$3.62
|
| Rate for Payer: Healthscope Whirlpool |
$3.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.16
|
| Rate for Payer: PACE SWMI |
$3.01
|
| Rate for Payer: PHP Medicare Advantage |
$3.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.00
|
| Rate for Payer: Priority Health Medicare |
$3.01
|
| Rate for Payer: UHC Medicare Advantage |
$3.10
|
|
|
PR PROCTOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$3,022.00
|
|
|
Service Code
|
HCPCS 45540
|
| Min. Negotiated Rate |
$667.33 |
| Max. Negotiated Rate |
$2,115.40 |
| Rate for Payer: Aetna Commercial |
$1,389.19
|
| Rate for Payer: Aetna Medicare |
$1,036.71
|
| Rate for Payer: BCBS Complete |
$700.70
|
| Rate for Payer: BCBS MAPPO |
$1,036.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,895.01
|
| Rate for Payer: BCN Commercial |
$1,528.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,036.71
|
| Rate for Payer: Cash Price |
$2,417.60
|
| Rate for Payer: Cash Price |
$2,417.60
|
| Rate for Payer: Cofinity Commercial |
$1,389.19
|
| Rate for Payer: Cofinity Commercial |
$1,492.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,036.71
|
| Rate for Payer: Healthscope Commercial |
$1,244.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,244.05
|
| Rate for Payer: Meridian Medicaid |
$700.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,088.55
|
| Rate for Payer: PACE SWMI |
$1,036.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,036.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,115.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,838.59
|
| Rate for Payer: Priority Health Medicare |
$1,036.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,838.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,067.81
|
|
|
PR PROCTOPEXY PERINEAL APPROACH
|
Professional
|
Both
|
$1,625.00
|
|
|
Service Code
|
HCPCS 45541
|
| Min. Negotiated Rate |
$598.74 |
| Max. Negotiated Rate |
$2,270.63 |
| Rate for Payer: Aetna Commercial |
$1,238.98
|
| Rate for Payer: Aetna Medicare |
$924.61
|
| Rate for Payer: BCBS Complete |
$628.68
|
| Rate for Payer: BCBS MAPPO |
$924.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,270.63
|
| Rate for Payer: BCN Commercial |
$1,368.30
|
| Rate for Payer: BCN Medicare Advantage |
$924.61
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cofinity Commercial |
$1,331.44
|
| Rate for Payer: Cofinity Commercial |
$1,238.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$924.61
|
| Rate for Payer: Healthscope Commercial |
$1,109.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,109.53
|
| Rate for Payer: Meridian Medicaid |
$628.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$970.84
|
| Rate for Payer: PACE SWMI |
$924.61
|
| Rate for Payer: PHP Medicare Advantage |
$924.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,646.32
|
| Rate for Payer: Priority Health Medicare |
$924.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,646.32
|
| Rate for Payer: UHC Medicare Advantage |
$952.35
|
|
|
PR PROCTOPEXY W/SIGMOID RESCJ ABDL APPR
|
Professional
|
Both
|
$3,618.00
|
|
|
Service Code
|
HCPCS 45550
|
| Min. Negotiated Rate |
$921.86 |
| Max. Negotiated Rate |
$2,546.50 |
| Rate for Payer: Aetna Commercial |
$1,924.75
|
| Rate for Payer: Aetna Medicare |
$1,436.38
|
| Rate for Payer: BCBS Complete |
$967.95
|
| Rate for Payer: BCBS MAPPO |
$1,436.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,697.43
|
| Rate for Payer: BCN Commercial |
$2,116.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,436.38
|
| Rate for Payer: Cash Price |
$2,894.40
|
| Rate for Payer: Cash Price |
$2,894.40
|
| Rate for Payer: Cofinity Commercial |
$2,068.39
|
| Rate for Payer: Cofinity Commercial |
$1,924.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,436.38
|
| Rate for Payer: Healthscope Commercial |
$1,723.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,723.66
|
| Rate for Payer: Meridian Medicaid |
$967.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,508.20
|
| Rate for Payer: PACE SWMI |
$1,436.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,436.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$921.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,532.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,546.50
|
| Rate for Payer: Priority Health Medicare |
$1,436.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,546.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,479.47
|
|
|
PR PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE
|
Professional
|
Both
|
$1,654.00
|
|
|
Service Code
|
HCPCS 45505
|
| Min. Negotiated Rate |
$386.60 |
| Max. Negotiated Rate |
$2,064.60 |
| Rate for Payer: Aetna Commercial |
$791.75
|
| Rate for Payer: Aetna Medicare |
$590.86
|
| Rate for Payer: BCBS Complete |
$405.93
|
| Rate for Payer: BCBS MAPPO |
$590.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,064.60
|
| Rate for Payer: BCN Commercial |
$882.55
|
| Rate for Payer: BCN Medicare Advantage |
$590.86
|
| Rate for Payer: Cash Price |
$1,323.20
|
| Rate for Payer: Cash Price |
$1,323.20
|
| Rate for Payer: Cofinity Commercial |
$850.84
|
| Rate for Payer: Cofinity Commercial |
$791.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.86
|
| Rate for Payer: Healthscope Commercial |
$709.03
|
| Rate for Payer: Healthscope Whirlpool |
$709.03
|
| Rate for Payer: Meridian Medicaid |
$405.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$620.40
|
| Rate for Payer: PACE SWMI |
$590.86
|
| Rate for Payer: PHP Medicare Advantage |
$590.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,061.87
|
| Rate for Payer: Priority Health Medicare |
$590.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,061.87
|
| Rate for Payer: UHC Medicare Advantage |
$608.59
|
|
|
PR PROCTOPLASTY STENOSIS
|
Professional
|
Both
|
$1,118.00
|
|
|
Service Code
|
HCPCS 45500
|
| Min. Negotiated Rate |
$366.79 |
| Max. Negotiated Rate |
$2,757.73 |
| Rate for Payer: Aetna Commercial |
$753.99
|
| Rate for Payer: Aetna Medicare |
$562.68
|
| Rate for Payer: BCBS Complete |
$385.13
|
| Rate for Payer: BCBS MAPPO |
$562.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,757.73
|
| Rate for Payer: BCN Commercial |
$836.62
|
| Rate for Payer: BCN Medicare Advantage |
$562.68
|
| Rate for Payer: Cash Price |
$894.40
|
| Rate for Payer: Cash Price |
$894.40
|
| Rate for Payer: Cofinity Commercial |
$810.26
|
| Rate for Payer: Cofinity Commercial |
$753.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.68
|
| Rate for Payer: Healthscope Commercial |
$675.22
|
| Rate for Payer: Healthscope Whirlpool |
$675.22
|
| Rate for Payer: Meridian Medicaid |
$385.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$590.81
|
| Rate for Payer: PACE SWMI |
$562.68
|
| Rate for Payer: PHP Medicare Advantage |
$562.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,006.61
|
| Rate for Payer: Priority Health Medicare |
$562.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,006.61
|
| Rate for Payer: UHC Medicare Advantage |
$579.56
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
OP
|
$193.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$135.10 |
| Max. Negotiated Rate |
$1,015.50 |
| Rate for Payer: Aetna Commercial |
$173.70
|
| Rate for Payer: Aetna Medicare |
$812.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,015.50
|
| Rate for Payer: ASR ASR |
$187.21
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$149.63
|
| Rate for Payer: BCN Commercial |
$149.63
|
| Rate for Payer: BCN Medicare Advantage |
$812.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cofinity Commercial |
$181.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
| Rate for Payer: Healthscope Commercial |
$193.00
|
| Rate for Payer: Healthscope Whirlpool |
$187.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$812.40
|
| Rate for Payer: Mclaren Commercial |
$173.70
|
| Rate for Payer: Mclaren Medicaid |
$444.38
|
| Rate for Payer: Mclaren Medicare |
$812.40
|
| Rate for Payer: Meridian Medicaid |
$466.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.05
|
| Rate for Payer: PACE Medicare |
$771.78
|
| Rate for Payer: PACE SWMI |
$812.40
|
| Rate for Payer: PHP Commercial |
$893.64
|
| Rate for Payer: PHP Medicaid |
$444.38
|
| Rate for Payer: PHP Medicare Advantage |
$812.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.63
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$137.03
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.84
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: VA VA |
$812.40
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
IP
|
$193.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$135.10 |
| Max. Negotiated Rate |
$193.00 |
| Rate for Payer: Aetna Commercial |
$173.70
|
| Rate for Payer: ASR ASR |
$187.21
|
| Rate for Payer: BCBS Trust/PPO |
$149.63
|
| Rate for Payer: BCN Commercial |
$149.63
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cofinity Commercial |
$181.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.40
|
| Rate for Payer: Healthscope Commercial |
$193.00
|
| Rate for Payer: Healthscope Whirlpool |
$187.21
|
| Rate for Payer: Mclaren Commercial |
$173.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.84
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$193.00
|
|
|
Service Code
|
HCPCS 45300
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$502.41 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$47.23
|
| Rate for Payer: BCBS Complete |
$32.20
|
| Rate for Payer: BCBS MAPPO |
$47.23
|
| Rate for Payer: BCBS Trust/PPO |
$502.41
|
| Rate for Payer: BCN Commercial |
$151.96
|
| Rate for Payer: BCN Medicare Advantage |
$47.23
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cofinity Commercial |
$68.01
|
| Rate for Payer: Cofinity Commercial |
$63.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.23
|
| Rate for Payer: Healthscope Commercial |
$56.68
|
| Rate for Payer: Healthscope Whirlpool |
$56.68
|
| Rate for Payer: Meridian Medicaid |
$32.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.59
|
| Rate for Payer: PACE SWMI |
$47.23
|
| Rate for Payer: PHP Medicare Advantage |
$47.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.08
|
| Rate for Payer: Priority Health Medicare |
$47.23
|
| Rate for Payer: Priority Health Narrow Network |
$84.08
|
| Rate for Payer: UHC Medicare Advantage |
$48.65
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$193.00
|
|
|
Service Code
|
HCPCS 45300
|
| Hospital Charge Code |
45300
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$502.41 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$47.23
|
| Rate for Payer: BCBS Complete |
$32.20
|
| Rate for Payer: BCBS MAPPO |
$47.23
|
| Rate for Payer: BCBS Trust/PPO |
$502.41
|
| Rate for Payer: BCN Commercial |
$151.96
|
| Rate for Payer: BCN Medicare Advantage |
$47.23
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cofinity Commercial |
$68.01
|
| Rate for Payer: Cofinity Commercial |
$63.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.23
|
| Rate for Payer: Healthscope Commercial |
$56.68
|
| Rate for Payer: Healthscope Whirlpool |
$56.68
|
| Rate for Payer: Meridian Medicaid |
$32.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.59
|
| Rate for Payer: PACE SWMI |
$47.23
|
| Rate for Payer: PHP Medicare Advantage |
$47.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.08
|
| Rate for Payer: Priority Health Medicare |
$47.23
|
| Rate for Payer: Priority Health Narrow Network |
$84.08
|
| Rate for Payer: UHC Medicare Advantage |
$48.65
|
|
