|
PR PSA, TOTAL SCREENING
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS G0103
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$1,566.94 |
| Rate for Payer: Aetna Commercial |
$25.88
|
| Rate for Payer: Aetna Medicare |
$19.31
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS MAPPO |
$19.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,566.94
|
| Rate for Payer: BCN Commercial |
$14.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.31
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$25.88
|
| Rate for Payer: Cofinity Commercial |
$27.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.31
|
| Rate for Payer: Healthscope Commercial |
$23.17
|
| Rate for Payer: Healthscope Whirlpool |
$23.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.28
|
| Rate for Payer: PACE SWMI |
$19.31
|
| Rate for Payer: PHP Medicare Advantage |
$19.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.04
|
| Rate for Payer: Priority Health Medicare |
$19.31
|
| Rate for Payer: Priority Health Narrow Network |
$20.04
|
| Rate for Payer: UHC Medicare Advantage |
$19.89
|
|
|
PR PSYCHIATRIC DIAGNOSTIC EVALUATION
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 90791
|
| Min. Negotiated Rate |
$94.36 |
| Max. Negotiated Rate |
$215.31 |
| Rate for Payer: Aetna Commercial |
$200.36
|
| Rate for Payer: Aetna Medicare |
$149.52
|
| Rate for Payer: BCBS Complete |
$99.08
|
| Rate for Payer: BCBS MAPPO |
$149.52
|
| Rate for Payer: BCBS Trust/PPO |
$203.40
|
| Rate for Payer: BCN Commercial |
$202.61
|
| Rate for Payer: BCN Medicare Advantage |
$149.52
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$200.36
|
| Rate for Payer: Cofinity Commercial |
$215.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.52
|
| Rate for Payer: Healthscope Commercial |
$179.42
|
| Rate for Payer: Healthscope Whirlpool |
$179.42
|
| Rate for Payer: Meridian Medicaid |
$99.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.00
|
| Rate for Payer: PACE SWMI |
$149.52
|
| Rate for Payer: PHP Medicare Advantage |
$149.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.98
|
| Rate for Payer: Priority Health Medicare |
$149.52
|
| Rate for Payer: Priority Health Narrow Network |
$159.98
|
| Rate for Payer: UHC Medicare Advantage |
$154.01
|
|
|
PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 90792
|
| Min. Negotiated Rate |
$108.20 |
| Max. Negotiated Rate |
$245.35 |
| Rate for Payer: Aetna Commercial |
$228.31
|
| Rate for Payer: Aetna Medicare |
$170.38
|
| Rate for Payer: BCBS Complete |
$113.61
|
| Rate for Payer: BCBS MAPPO |
$170.38
|
| Rate for Payer: BCBS Trust/PPO |
$140.00
|
| Rate for Payer: BCN Commercial |
$227.74
|
| Rate for Payer: BCN Medicare Advantage |
$170.38
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$228.31
|
| Rate for Payer: Cofinity Commercial |
$245.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.38
|
| Rate for Payer: Healthscope Commercial |
$204.46
|
| Rate for Payer: Healthscope Whirlpool |
$204.46
|
| Rate for Payer: Meridian Medicaid |
$113.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.90
|
| Rate for Payer: PACE SWMI |
$170.38
|
| Rate for Payer: PHP Medicare Advantage |
$170.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.10
|
| Rate for Payer: Priority Health Medicare |
$170.38
|
| Rate for Payer: Priority Health Narrow Network |
$165.10
|
| Rate for Payer: UHC Medicare Advantage |
$175.49
|
|
|
PR PSYCHOANALYSIS
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 90845
|
| Min. Negotiated Rate |
$78.80 |
| Max. Negotiated Rate |
$353.96 |
| Rate for Payer: Aetna Commercial |
$111.11
|
| Rate for Payer: Aetna Medicare |
$82.92
|
| Rate for Payer: BCBS Complete |
$78.80
|
| Rate for Payer: BCBS MAPPO |
$82.92
|
| Rate for Payer: BCBS Trust/PPO |
$353.96
|
| Rate for Payer: BCN Commercial |
$99.96
|
| Rate for Payer: BCN Medicare Advantage |
$82.92
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$119.40
|
| Rate for Payer: Cofinity Commercial |
$111.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.92
|
| Rate for Payer: Healthscope Commercial |
$99.50
|
| Rate for Payer: Healthscope Whirlpool |
$99.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.07
|
| Rate for Payer: PACE SWMI |
$82.92
|
| Rate for Payer: PHP Medicare Advantage |
$82.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.24
|
| Rate for Payer: Priority Health Medicare |
$82.92
|
| Rate for Payer: Priority Health Narrow Network |
$103.24
|
| Rate for Payer: UHC Medicare Advantage |
$85.41
|
|
|
PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR
|
Professional
|
Both
|
$178.00
|
|
|
Service Code
|
HCPCS 96131
|
| Min. Negotiated Rate |
$47.93 |
| Max. Negotiated Rate |
$1,854.86 |
| Rate for Payer: Aetna Commercial |
$101.71
|
| Rate for Payer: Aetna Medicare |
$75.90
|
| Rate for Payer: BCBS Complete |
$50.33
|
| Rate for Payer: BCBS MAPPO |
$75.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,854.86
|
| Rate for Payer: BCN Commercial |
$125.10
|
| Rate for Payer: BCN Medicare Advantage |
$75.90
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cofinity Commercial |
$109.30
|
| Rate for Payer: Cofinity Commercial |
$101.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.90
|
| Rate for Payer: Healthscope Commercial |
$91.08
|
| Rate for Payer: Healthscope Whirlpool |
$91.08
|
| Rate for Payer: Meridian Medicaid |
$50.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.70
|
| Rate for Payer: PACE SWMI |
$75.90
|
| Rate for Payer: PHP Medicare Advantage |
$75.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.51
|
| Rate for Payer: Priority Health Medicare |
$75.90
|
| Rate for Payer: Priority Health Narrow Network |
$101.51
|
| Rate for Payer: UHC Medicare Advantage |
$78.18
|
|
|
PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 96130
|
| Min. Negotiated Rate |
$69.23 |
| Max. Negotiated Rate |
$1,286.94 |
| Rate for Payer: Aetna Commercial |
$143.89
|
| Rate for Payer: Aetna Medicare |
$107.38
|
| Rate for Payer: BCBS Complete |
$72.69
|
| Rate for Payer: BCBS MAPPO |
$107.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,286.94
|
| Rate for Payer: BCN Commercial |
$173.48
|
| Rate for Payer: BCN Medicare Advantage |
$107.38
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cofinity Commercial |
$154.63
|
| Rate for Payer: Cofinity Commercial |
$143.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.38
|
| Rate for Payer: Healthscope Commercial |
$128.86
|
| Rate for Payer: Healthscope Whirlpool |
$128.86
|
| Rate for Payer: Meridian Medicaid |
$72.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.75
|
| Rate for Payer: PACE SWMI |
$107.38
|
| Rate for Payer: PHP Medicare Advantage |
$107.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.18
|
| Rate for Payer: Priority Health Medicare |
$107.38
|
| Rate for Payer: Priority Health Narrow Network |
$144.18
|
| Rate for Payer: UHC Medicare Advantage |
$110.60
|
|
|
PR PSYCHOLOGIC TESTING ADMIN BY COMPUTER
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 96103
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.80
|
|
|
PR PSYCHOLOGIC TESTING BY PSYCH/PHYS
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 96101
|
| Min. Negotiated Rate |
$58.40 |
| Max. Negotiated Rate |
$102.20 |
| Rate for Payer: BCBS Complete |
$58.40
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
|
|
PR PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 90785
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$294.26 |
| Rate for Payer: Aetna Commercial |
$17.54
|
| Rate for Payer: Aetna Medicare |
$13.09
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS MAPPO |
$13.09
|
| Rate for Payer: BCBS Trust/PPO |
$294.26
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$13.09
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$18.85
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.09
|
| Rate for Payer: Healthscope Commercial |
$15.71
|
| Rate for Payer: Healthscope Whirlpool |
$15.71
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.74
|
| Rate for Payer: PACE SWMI |
$13.09
|
| Rate for Payer: PHP Medicare Advantage |
$13.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.51
|
| Rate for Payer: Priority Health Medicare |
$13.09
|
| Rate for Payer: Priority Health Narrow Network |
$6.51
|
| Rate for Payer: UHC Medicare Advantage |
$13.48
|
|
|
PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 90840
|
| Min. Negotiated Rate |
$41.32 |
| Max. Negotiated Rate |
$660.38 |
| Rate for Payer: Aetna Commercial |
$83.19
|
| Rate for Payer: Aetna Medicare |
$62.08
|
| Rate for Payer: BCBS Complete |
$43.39
|
| Rate for Payer: BCBS MAPPO |
$62.08
|
| Rate for Payer: BCBS Trust/PPO |
$660.38
|
| Rate for Payer: BCN Commercial |
$81.28
|
| Rate for Payer: BCN Medicare Advantage |
$62.08
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cofinity Commercial |
$89.40
|
| Rate for Payer: Cofinity Commercial |
$83.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.08
|
| Rate for Payer: Healthscope Commercial |
$74.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.50
|
| Rate for Payer: Meridian Medicaid |
$43.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.18
|
| Rate for Payer: PACE SWMI |
$62.08
|
| Rate for Payer: PHP Medicare Advantage |
$62.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.28
|
| Rate for Payer: Priority Health Medicare |
$62.08
|
| Rate for Payer: Priority Health Narrow Network |
$56.28
|
| Rate for Payer: UHC Medicare Advantage |
$63.94
|
|
|
PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 90839
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$311.17 |
| Rate for Payer: Aetna Commercial |
$166.04
|
| Rate for Payer: Aetna Medicare |
$123.91
|
| Rate for Payer: BCBS Complete |
$86.55
|
| Rate for Payer: BCBS MAPPO |
$123.91
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$163.74
|
| Rate for Payer: BCN Medicare Advantage |
$123.91
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$166.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.91
|
| Rate for Payer: Healthscope Commercial |
$148.69
|
| Rate for Payer: Healthscope Whirlpool |
$148.69
|
| Rate for Payer: Meridian Medicaid |
$86.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$130.11
|
| Rate for Payer: PACE SWMI |
$123.91
|
| Rate for Payer: PHP Medicare Advantage |
$123.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.13
|
| Rate for Payer: Priority Health Medicare |
$123.91
|
| Rate for Payer: Priority Health Narrow Network |
$158.13
|
| Rate for Payer: UHC Medicare Advantage |
$127.63
|
|
|
PR PSYCHOTHERAPY W/PATIENT 30 MINUTES
|
Professional
|
Both
|
$109.00
|
|
|
Service Code
|
HCPCS 90832
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$1,348.22 |
| Rate for Payer: Aetna Commercial |
$88.25
|
| Rate for Payer: Aetna Medicare |
$65.86
|
| Rate for Payer: BCBS Complete |
$45.85
|
| Rate for Payer: BCBS MAPPO |
$65.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,348.22
|
| Rate for Payer: BCN Commercial |
$87.56
|
| Rate for Payer: BCN Medicare Advantage |
$65.86
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cofinity Commercial |
$88.25
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.86
|
| Rate for Payer: Healthscope Commercial |
$79.03
|
| Rate for Payer: Healthscope Whirlpool |
$79.03
|
| Rate for Payer: Meridian Medicaid |
$45.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.15
|
| Rate for Payer: PACE SWMI |
$65.86
|
| Rate for Payer: PHP Medicare Advantage |
$65.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.97
|
| Rate for Payer: Priority Health Medicare |
$65.86
|
| Rate for Payer: Priority Health Narrow Network |
$66.97
|
| Rate for Payer: UHC Medicare Advantage |
$67.84
|
|
|
PR PSYCHOTHERAPY W/PATIENT 45 MINUTES
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 90834
|
| Min. Negotiated Rate |
$57.72 |
| Max. Negotiated Rate |
$300.07 |
| Rate for Payer: Aetna Commercial |
$117.06
|
| Rate for Payer: Aetna Medicare |
$87.36
|
| Rate for Payer: BCBS Complete |
$60.61
|
| Rate for Payer: BCBS MAPPO |
$87.36
|
| Rate for Payer: BCBS Trust/PPO |
$300.07
|
| Rate for Payer: BCN Commercial |
$115.84
|
| Rate for Payer: BCN Medicare Advantage |
$87.36
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$117.06
|
| Rate for Payer: Cofinity Commercial |
$125.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.36
|
| Rate for Payer: Healthscope Commercial |
$104.83
|
| Rate for Payer: Healthscope Whirlpool |
$104.83
|
| Rate for Payer: Meridian Medicaid |
$60.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.73
|
| Rate for Payer: PACE SWMI |
$87.36
|
| Rate for Payer: PHP Medicare Advantage |
$87.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.96
|
| Rate for Payer: Priority Health Medicare |
$87.36
|
| Rate for Payer: Priority Health Narrow Network |
$103.96
|
| Rate for Payer: UHC Medicare Advantage |
$89.98
|
|
|
PR PSYCHOTHERAPY W/PATIENT 60 MINUTES
|
Professional
|
Both
|
$233.00
|
|
|
Service Code
|
HCPCS 90837
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$286.87 |
| Rate for Payer: Aetna Commercial |
$172.00
|
| Rate for Payer: Aetna Medicare |
$128.36
|
| Rate for Payer: BCBS Complete |
$89.46
|
| Rate for Payer: BCBS MAPPO |
$128.36
|
| Rate for Payer: BCBS Trust/PPO |
$286.87
|
| Rate for Payer: BCN Commercial |
$170.41
|
| Rate for Payer: BCN Medicare Advantage |
$128.36
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cofinity Commercial |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$184.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.36
|
| Rate for Payer: Healthscope Commercial |
$154.03
|
| Rate for Payer: Healthscope Whirlpool |
$154.03
|
| Rate for Payer: Meridian Medicaid |
$89.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.78
|
| Rate for Payer: PACE SWMI |
$128.36
|
| Rate for Payer: PHP Medicare Advantage |
$128.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.60
|
| Rate for Payer: Priority Health Medicare |
$128.36
|
| Rate for Payer: Priority Health Narrow Network |
$151.60
|
| Rate for Payer: UHC Medicare Advantage |
$132.21
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 90833
|
| Min. Negotiated Rate |
$36.72 |
| Max. Negotiated Rate |
$300.07 |
| Rate for Payer: Aetna Commercial |
$82.21
|
| Rate for Payer: Aetna Medicare |
$61.35
|
| Rate for Payer: BCBS Complete |
$42.94
|
| Rate for Payer: BCBS MAPPO |
$61.35
|
| Rate for Payer: BCBS Trust/PPO |
$300.07
|
| Rate for Payer: BCN Commercial |
$36.72
|
| Rate for Payer: BCN Medicare Advantage |
$61.35
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$82.21
|
| Rate for Payer: Cofinity Commercial |
$88.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.35
|
| Rate for Payer: Healthscope Commercial |
$73.62
|
| Rate for Payer: Healthscope Whirlpool |
$73.62
|
| Rate for Payer: Meridian Medicaid |
$42.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.42
|
| Rate for Payer: PACE SWMI |
$61.35
|
| Rate for Payer: PHP Medicare Advantage |
$61.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.27
|
| Rate for Payer: Priority Health Medicare |
$61.35
|
| Rate for Payer: Priority Health Narrow Network |
$56.27
|
| Rate for Payer: UHC Medicare Advantage |
$63.19
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN
|
Professional
|
Both
|
$169.00
|
|
|
Service Code
|
HCPCS 90836
|
| Min. Negotiated Rate |
$46.57 |
| Max. Negotiated Rate |
$318.04 |
| Rate for Payer: Aetna Commercial |
$104.25
|
| Rate for Payer: Aetna Medicare |
$77.80
|
| Rate for Payer: BCBS Complete |
$54.35
|
| Rate for Payer: BCBS MAPPO |
$77.80
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$46.57
|
| Rate for Payer: BCN Medicare Advantage |
$77.80
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cofinity Commercial |
$112.03
|
| Rate for Payer: Cofinity Commercial |
$104.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.80
|
| Rate for Payer: Healthscope Commercial |
$93.36
|
| Rate for Payer: Healthscope Whirlpool |
$93.36
|
| Rate for Payer: Meridian Medicaid |
$54.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$81.69
|
| Rate for Payer: PACE SWMI |
$77.80
|
| Rate for Payer: PHP Medicare Advantage |
$77.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.08
|
| Rate for Payer: Priority Health Medicare |
$77.80
|
| Rate for Payer: Priority Health Narrow Network |
$92.08
|
| Rate for Payer: UHC Medicare Advantage |
$80.13
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 90838
|
| Min. Negotiated Rate |
$61.62 |
| Max. Negotiated Rate |
$162.40 |
| Rate for Payer: Aetna Commercial |
$138.34
|
| Rate for Payer: Aetna Medicare |
$103.24
|
| Rate for Payer: BCBS Complete |
$72.02
|
| Rate for Payer: BCBS MAPPO |
$103.24
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: BCN Commercial |
$61.62
|
| Rate for Payer: BCN Medicare Advantage |
$103.24
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cofinity Commercial |
$148.67
|
| Rate for Payer: Cofinity Commercial |
$138.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.24
|
| Rate for Payer: Healthscope Commercial |
$123.89
|
| Rate for Payer: Healthscope Whirlpool |
$123.89
|
| Rate for Payer: Meridian Medicaid |
$72.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.40
|
| Rate for Payer: PACE SWMI |
$103.24
|
| Rate for Payer: PHP Medicare Advantage |
$103.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.89
|
| Rate for Payer: Priority Health Medicare |
$103.24
|
| Rate for Payer: Priority Health Narrow Network |
$147.89
|
| Rate for Payer: UHC Medicare Advantage |
$106.34
|
|
|
PR PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 96146
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$303.77 |
| Rate for Payer: Aetna Commercial |
$2.97
|
| Rate for Payer: Aetna Medicare |
$2.22
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$2.22
|
| Rate for Payer: BCBS Trust/PPO |
$303.77
|
| Rate for Payer: BCN Commercial |
$3.42
|
| Rate for Payer: BCN Medicare Advantage |
$2.22
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$2.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.22
|
| Rate for Payer: Healthscope Commercial |
$2.66
|
| Rate for Payer: Healthscope Whirlpool |
$2.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.33
|
| Rate for Payer: PACE SWMI |
$2.22
|
| Rate for Payer: PHP Medicare Advantage |
$2.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.14
|
| Rate for Payer: Priority Health Medicare |
$2.22
|
| Rate for Payer: Priority Health Narrow Network |
$3.14
|
| Rate for Payer: UHC Medicare Advantage |
$2.29
|
|
|
PR PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 96137
|
| Min. Negotiated Rate |
$11.29 |
| Max. Negotiated Rate |
$308.53 |
| Rate for Payer: Aetna Commercial |
$23.87
|
| Rate for Payer: Aetna Medicare |
$17.81
|
| Rate for Payer: BCBS Complete |
$11.85
|
| Rate for Payer: BCBS MAPPO |
$17.81
|
| Rate for Payer: BCBS Trust/PPO |
$308.53
|
| Rate for Payer: BCN Commercial |
$56.68
|
| Rate for Payer: BCN Medicare Advantage |
$17.81
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.81
|
| Rate for Payer: Healthscope Commercial |
$21.37
|
| Rate for Payer: Healthscope Whirlpool |
$21.37
|
| Rate for Payer: Meridian Medicaid |
$11.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.70
|
| Rate for Payer: PACE SWMI |
$17.81
|
| Rate for Payer: PHP Medicare Advantage |
$17.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.80
|
| Rate for Payer: Priority Health Medicare |
$17.81
|
| Rate for Payer: Priority Health Narrow Network |
$23.80
|
| Rate for Payer: UHC Medicare Advantage |
$18.34
|
|
|
PR PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 96138
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$313.81 |
| Rate for Payer: Aetna Commercial |
$41.86
|
| Rate for Payer: Aetna Medicare |
$31.24
|
| Rate for Payer: BCBS Complete |
$28.80
|
| Rate for Payer: BCBS MAPPO |
$31.24
|
| Rate for Payer: BCBS Trust/PPO |
$313.81
|
| Rate for Payer: BCN Commercial |
$49.36
|
| Rate for Payer: BCN Medicare Advantage |
$31.24
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Cofinity Commercial |
$44.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.24
|
| Rate for Payer: Healthscope Commercial |
$37.49
|
| Rate for Payer: Healthscope Whirlpool |
$37.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.80
|
| Rate for Payer: PACE SWMI |
$31.24
|
| Rate for Payer: PHP Medicare Advantage |
$31.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.37
|
| Rate for Payer: Priority Health Medicare |
$31.24
|
| Rate for Payer: Priority Health Narrow Network |
$45.37
|
| Rate for Payer: UHC Medicare Advantage |
$32.18
|
|
|
PR PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 96139
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$342.87 |
| Rate for Payer: Aetna Commercial |
$43.09
|
| Rate for Payer: Aetna Medicare |
$32.16
|
| Rate for Payer: BCBS Complete |
$28.80
|
| Rate for Payer: BCBS MAPPO |
$32.16
|
| Rate for Payer: BCBS Trust/PPO |
$342.87
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: BCN Medicare Advantage |
$32.16
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$46.31
|
| Rate for Payer: Cofinity Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.16
|
| Rate for Payer: Healthscope Commercial |
$38.59
|
| Rate for Payer: Healthscope Whirlpool |
$38.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.77
|
| Rate for Payer: PACE SWMI |
$32.16
|
| Rate for Payer: PHP Medicare Advantage |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.71
|
| Rate for Payer: Priority Health Medicare |
$32.16
|
| Rate for Payer: Priority Health Narrow Network |
$46.71
|
| Rate for Payer: UHC Medicare Advantage |
$33.12
|
|
|
PR PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 96136
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$227.17 |
| Rate for Payer: Aetna Commercial |
$30.91
|
| Rate for Payer: Aetna Medicare |
$23.07
|
| Rate for Payer: BCBS Complete |
$15.44
|
| Rate for Payer: BCBS MAPPO |
$23.07
|
| Rate for Payer: BCBS Trust/PPO |
$227.17
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Medicare Advantage |
$23.07
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$30.91
|
| Rate for Payer: Cofinity Commercial |
$33.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.07
|
| Rate for Payer: Healthscope Commercial |
$27.68
|
| Rate for Payer: Healthscope Whirlpool |
$27.68
|
| Rate for Payer: Meridian Medicaid |
$15.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.22
|
| Rate for Payer: PACE SWMI |
$23.07
|
| Rate for Payer: PHP Medicare Advantage |
$23.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.99
|
| Rate for Payer: Priority Health Medicare |
$23.07
|
| Rate for Payer: Priority Health Narrow Network |
$30.99
|
| Rate for Payer: UHC Medicare Advantage |
$23.76
|
|
|
PR PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH
|
Professional
|
Both
|
$2,175.00
|
|
|
Service Code
|
HCPCS 31040
|
| Min. Negotiated Rate |
$518.66 |
| Max. Negotiated Rate |
$1,522.50 |
| Rate for Payer: Aetna Commercial |
$1,058.02
|
| Rate for Payer: Aetna Medicare |
$789.57
|
| Rate for Payer: BCBS Complete |
$544.59
|
| Rate for Payer: BCBS MAPPO |
$789.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.47
|
| Rate for Payer: BCN Commercial |
$1,190.91
|
| Rate for Payer: BCN Medicare Advantage |
$789.57
|
| Rate for Payer: Cash Price |
$1,740.00
|
| Rate for Payer: Cash Price |
$1,740.00
|
| Rate for Payer: Cofinity Commercial |
$1,058.02
|
| Rate for Payer: Cofinity Commercial |
$1,136.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$789.57
|
| Rate for Payer: Healthscope Commercial |
$947.48
|
| Rate for Payer: Healthscope Whirlpool |
$947.48
|
| Rate for Payer: Meridian Medicaid |
$544.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$829.05
|
| Rate for Payer: PACE SWMI |
$789.57
|
| Rate for Payer: PHP Medicare Advantage |
$789.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$518.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,128.44
|
| Rate for Payer: Priority Health Medicare |
$789.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,128.44
|
| Rate for Payer: UHC Medicare Advantage |
$813.26
|
|
|
PR PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 96160
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$124.15 |
| Rate for Payer: Aetna Commercial |
$3.31
|
| Rate for Payer: Aetna Medicare |
$2.47
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$2.47
|
| Rate for Payer: BCBS Trust/PPO |
$124.15
|
| Rate for Payer: BCN Commercial |
$3.91
|
| Rate for Payer: BCN Medicare Advantage |
$2.47
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$3.56
|
| Rate for Payer: Cofinity Commercial |
$3.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.47
|
| Rate for Payer: Healthscope Commercial |
$2.96
|
| Rate for Payer: Healthscope Whirlpool |
$2.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.59
|
| Rate for Payer: PACE SWMI |
$2.47
|
| Rate for Payer: PHP Medicare Advantage |
$2.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.43
|
| Rate for Payer: Priority Health Medicare |
$2.47
|
| Rate for Payer: Priority Health Narrow Network |
$5.43
|
| Rate for Payer: UHC Medicare Advantage |
$2.54
|
|
|
PR PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS
|
Professional
|
Both
|
$5,465.00
|
|
|
Service Code
|
HCPCS 33910
|
| Min. Negotiated Rate |
$727.47 |
| Max. Negotiated Rate |
$4,112.03 |
| Rate for Payer: Aetna Commercial |
$3,477.35
|
| Rate for Payer: Aetna Medicare |
$2,595.04
|
| Rate for Payer: BCBS Complete |
$1,711.59
|
| Rate for Payer: BCBS MAPPO |
$2,595.04
|
| Rate for Payer: BCBS Trust/PPO |
$727.47
|
| Rate for Payer: BCN Commercial |
$3,777.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,595.04
|
| Rate for Payer: Cash Price |
$4,372.00
|
| Rate for Payer: Cash Price |
$4,372.00
|
| Rate for Payer: Cofinity Commercial |
$3,736.86
|
| Rate for Payer: Cofinity Commercial |
$3,477.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,595.04
|
| Rate for Payer: Healthscope Commercial |
$3,114.05
|
| Rate for Payer: Healthscope Whirlpool |
$3,114.05
|
| Rate for Payer: Meridian Medicaid |
$1,711.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,724.79
|
| Rate for Payer: PACE SWMI |
$2,595.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,595.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,630.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,112.03
|
| Rate for Payer: Priority Health Medicare |
$2,595.04
|
| Rate for Payer: Priority Health Narrow Network |
$4,112.03
|
| Rate for Payer: UHC Medicare Advantage |
$2,672.89
|
|
