|
PR PULMONARY COMPLIANCE STUDY
|
Professional
|
Both
|
$169.00
|
|
|
Service Code
|
HCPCS 94750
|
| Min. Negotiated Rate |
$67.60 |
| Max. Negotiated Rate |
$118.30 |
| Rate for Payer: BCBS Complete |
$67.60
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
|
|
PR PULMONARY STRESS TESTING
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 94618
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$442.72 |
| Rate for Payer: Aetna Commercial |
$43.54
|
| Rate for Payer: Aetna Medicare |
$32.49
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS MAPPO |
$32.49
|
| Rate for Payer: BCBS Trust/PPO |
$442.72
|
| Rate for Payer: BCN Commercial |
$48.87
|
| Rate for Payer: BCN Medicare Advantage |
$32.49
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$43.54
|
| Rate for Payer: Cofinity Commercial |
$46.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.49
|
| Rate for Payer: Healthscope Commercial |
$38.99
|
| Rate for Payer: Healthscope Whirlpool |
$38.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.11
|
| Rate for Payer: PACE SWMI |
$32.49
|
| Rate for Payer: PHP Medicare Advantage |
$32.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.92
|
| Rate for Payer: Priority Health Medicare |
$32.49
|
| Rate for Payer: Priority Health Narrow Network |
$44.92
|
| Rate for Payer: UHC Medicare Advantage |
$33.46
|
|
|
PR PULMONARY STRESS TESTING,SIMPLE
|
Professional
|
Both
|
$351.00
|
|
|
Service Code
|
HCPCS 94620
|
| Min. Negotiated Rate |
$140.40 |
| Max. Negotiated Rate |
$245.70 |
| Rate for Payer: BCBS Complete |
$140.40
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.70
|
|
|
PR PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$178.00
|
|
|
Service Code
|
HCPCS 11105
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$124.60 |
| Rate for Payer: Aetna Commercial |
$33.70
|
| Rate for Payer: Aetna Medicare |
$25.15
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$25.15
|
| Rate for Payer: BCBS Trust/PPO |
$23.50
|
| Rate for Payer: BCN Commercial |
$69.89
|
| Rate for Payer: BCN Medicare Advantage |
$25.15
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cofinity Commercial |
$33.70
|
| Rate for Payer: Cofinity Commercial |
$36.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.15
|
| Rate for Payer: Healthscope Commercial |
$30.18
|
| Rate for Payer: Healthscope Whirlpool |
$30.18
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.41
|
| Rate for Payer: PACE SWMI |
$25.15
|
| Rate for Payer: PHP Medicare Advantage |
$25.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.23
|
| Rate for Payer: Priority Health Medicare |
$25.15
|
| Rate for Payer: Priority Health Narrow Network |
$31.23
|
| Rate for Payer: UHC Medicare Advantage |
$25.90
|
|
|
PR PUNCH BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 11104
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Aetna Commercial |
$61.60
|
| Rate for Payer: Aetna Medicare |
$45.97
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS MAPPO |
$45.97
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$148.43
|
| Rate for Payer: BCN Medicare Advantage |
$45.97
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cofinity Commercial |
$66.20
|
| Rate for Payer: Cofinity Commercial |
$61.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.97
|
| Rate for Payer: Healthscope Commercial |
$55.16
|
| Rate for Payer: Healthscope Whirlpool |
$55.16
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.27
|
| Rate for Payer: PACE SWMI |
$45.97
|
| Rate for Payer: PHP Medicare Advantage |
$45.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.13
|
| Rate for Payer: Priority Health Medicare |
$45.97
|
| Rate for Payer: Priority Health Narrow Network |
$57.13
|
| Rate for Payer: UHC Medicare Advantage |
$47.35
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$211.00
|
|
|
Service Code
|
HCPCS 10160
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$153.14 |
| Rate for Payer: Aetna Commercial |
$125.46
|
| Rate for Payer: Aetna Medicare |
$93.63
|
| Rate for Payer: BCBS Complete |
$65.08
|
| Rate for Payer: BCBS MAPPO |
$93.63
|
| Rate for Payer: BCBS Trust/PPO |
$11.15
|
| Rate for Payer: BCN Commercial |
$153.14
|
| Rate for Payer: BCN Medicare Advantage |
$93.63
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$134.83
|
| Rate for Payer: Cofinity Commercial |
$125.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.63
|
| Rate for Payer: Healthscope Commercial |
$112.36
|
| Rate for Payer: Healthscope Whirlpool |
$112.36
|
| Rate for Payer: Meridian Medicaid |
$65.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.31
|
| Rate for Payer: PACE SWMI |
$93.63
|
| Rate for Payer: PHP Medicare Advantage |
$93.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.39
|
| Rate for Payer: Priority Health Medicare |
$93.63
|
| Rate for Payer: Priority Health Narrow Network |
$118.39
|
| Rate for Payer: UHC Medicare Advantage |
$96.44
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$211.00
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
10160
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$153.14 |
| Rate for Payer: Aetna Commercial |
$125.46
|
| Rate for Payer: Aetna Medicare |
$93.63
|
| Rate for Payer: BCBS Complete |
$65.08
|
| Rate for Payer: BCBS MAPPO |
$93.63
|
| Rate for Payer: BCBS Trust/PPO |
$11.15
|
| Rate for Payer: BCN Commercial |
$153.14
|
| Rate for Payer: BCN Medicare Advantage |
$93.63
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$134.83
|
| Rate for Payer: Cofinity Commercial |
$125.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.63
|
| Rate for Payer: Healthscope Commercial |
$112.36
|
| Rate for Payer: Healthscope Whirlpool |
$112.36
|
| Rate for Payer: Meridian Medicaid |
$65.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.31
|
| Rate for Payer: PACE SWMI |
$93.63
|
| Rate for Payer: PHP Medicare Advantage |
$93.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.39
|
| Rate for Payer: Priority Health Medicare |
$93.63
|
| Rate for Payer: Priority Health Narrow Network |
$118.39
|
| Rate for Payer: UHC Medicare Advantage |
$96.44
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Facility
|
OP
|
$211.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
10160
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$147.70 |
| Max. Negotiated Rate |
$443.04 |
| Rate for Payer: Aetna Commercial |
$189.90
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$204.67
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$163.59
|
| Rate for Payer: BCN Commercial |
$163.59
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$198.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$211.00
|
| Rate for Payer: Healthscope Whirlpool |
$204.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$189.90
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$179.35
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.36
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$168.29
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.68
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
10160
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$147.70 |
| Max. Negotiated Rate |
$211.00 |
| Rate for Payer: Aetna Commercial |
$189.90
|
| Rate for Payer: ASR ASR |
$204.67
|
| Rate for Payer: BCBS Trust/PPO |
$163.59
|
| Rate for Payer: BCN Commercial |
$163.59
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$198.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.80
|
| Rate for Payer: Healthscope Commercial |
$211.00
|
| Rate for Payer: Healthscope Whirlpool |
$204.67
|
| Rate for Payer: Mclaren Commercial |
$189.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$179.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.68
|
|
|
PR PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 19001
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna Medicare |
$20.32
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$20.32
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$38.12
|
| Rate for Payer: BCN Medicare Advantage |
$20.32
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$29.26
|
| Rate for Payer: Cofinity Commercial |
$27.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.32
|
| Rate for Payer: Healthscope Commercial |
$24.38
|
| Rate for Payer: Healthscope Whirlpool |
$24.38
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.34
|
| Rate for Payer: PACE SWMI |
$20.32
|
| Rate for Payer: PHP Medicare Advantage |
$20.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.07
|
| Rate for Payer: Priority Health Medicare |
$20.32
|
| Rate for Payer: Priority Health Narrow Network |
$25.07
|
| Rate for Payer: UHC Medicare Advantage |
$20.93
|
|
|
PR PUNCTURE ASPIRATION CYST BREAST
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 19000
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$56.35
|
| Rate for Payer: Aetna Medicare |
$42.05
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$42.05
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$149.54
|
| Rate for Payer: BCN Medicare Advantage |
$42.05
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$60.55
|
| Rate for Payer: Cofinity Commercial |
$56.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.05
|
| Rate for Payer: Healthscope Commercial |
$50.46
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.15
|
| Rate for Payer: PACE SWMI |
$42.05
|
| Rate for Payer: PHP Medicare Advantage |
$42.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.79
|
| Rate for Payer: Priority Health Medicare |
$42.05
|
| Rate for Payer: Priority Health Narrow Network |
$51.79
|
| Rate for Payer: UHC Medicare Advantage |
$43.31
|
|
|
PR PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX
|
Professional
|
Both
|
$393.00
|
|
|
Service Code
|
HCPCS 61070
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$355.02 |
| Rate for Payer: Aetna Commercial |
$74.37
|
| Rate for Payer: Aetna Medicare |
$55.50
|
| Rate for Payer: BCBS Complete |
$37.57
|
| Rate for Payer: BCBS MAPPO |
$55.50
|
| Rate for Payer: BCBS Trust/PPO |
$355.02
|
| Rate for Payer: BCN Commercial |
$113.90
|
| Rate for Payer: BCN Medicare Advantage |
$55.50
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cofinity Commercial |
$79.92
|
| Rate for Payer: Cofinity Commercial |
$74.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.50
|
| Rate for Payer: Healthscope Commercial |
$66.60
|
| Rate for Payer: Healthscope Whirlpool |
$66.60
|
| Rate for Payer: Meridian Medicaid |
$37.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.28
|
| Rate for Payer: PACE SWMI |
$55.50
|
| Rate for Payer: PHP Medicare Advantage |
$55.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.12
|
| Rate for Payer: Priority Health Medicare |
$55.50
|
| Rate for Payer: Priority Health Narrow Network |
$95.12
|
| Rate for Payer: UHC Medicare Advantage |
$57.16
|
|
|
PR PURE TONE AUDIOMETRY AIR & BONE
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 92553
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$1,526.79 |
| Rate for Payer: Aetna Commercial |
$53.85
|
| Rate for Payer: Aetna Medicare |
$40.19
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS MAPPO |
$40.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.79
|
| Rate for Payer: BCN Commercial |
$63.53
|
| Rate for Payer: BCN Medicare Advantage |
$40.19
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$57.87
|
| Rate for Payer: Cofinity Commercial |
$53.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.19
|
| Rate for Payer: Healthscope Commercial |
$48.23
|
| Rate for Payer: Healthscope Whirlpool |
$48.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.20
|
| Rate for Payer: PACE SWMI |
$40.19
|
| Rate for Payer: PHP Medicare Advantage |
$40.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.38
|
| Rate for Payer: Priority Health Medicare |
$40.19
|
| Rate for Payer: Priority Health Narrow Network |
$58.38
|
| Rate for Payer: UHC Medicare Advantage |
$41.40
|
|
|
PR PURE TONE AUDIOMETRY AIR ONLY
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 92552
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$1,476.07 |
| Rate for Payer: Aetna Commercial |
$43.93
|
| Rate for Payer: Aetna Medicare |
$32.78
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$32.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.07
|
| Rate for Payer: BCN Commercial |
$51.80
|
| Rate for Payer: BCN Medicare Advantage |
$32.78
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$43.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.78
|
| Rate for Payer: Healthscope Commercial |
$39.34
|
| Rate for Payer: Healthscope Whirlpool |
$39.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.42
|
| Rate for Payer: PACE SWMI |
$32.78
|
| Rate for Payer: PHP Medicare Advantage |
$32.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.61
|
| Rate for Payer: Priority Health Medicare |
$32.78
|
| Rate for Payer: Priority Health Narrow Network |
$47.61
|
| Rate for Payer: UHC Medicare Advantage |
$33.76
|
|
|
PR PVB THORACIC CONT CATHETER INFUSION W/IMG GID
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 64463
|
| Min. Negotiated Rate |
$51.33 |
| Max. Negotiated Rate |
$788.75 |
| Rate for Payer: Aetna Commercial |
$109.06
|
| Rate for Payer: Aetna Medicare |
$81.39
|
| Rate for Payer: BCBS Complete |
$53.90
|
| Rate for Payer: BCBS MAPPO |
$81.39
|
| Rate for Payer: BCBS Trust/PPO |
$788.75
|
| Rate for Payer: BCN Commercial |
$340.61
|
| Rate for Payer: BCN Medicare Advantage |
$81.39
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cofinity Commercial |
$109.06
|
| Rate for Payer: Cofinity Commercial |
$117.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.39
|
| Rate for Payer: Healthscope Commercial |
$97.67
|
| Rate for Payer: Healthscope Whirlpool |
$97.67
|
| Rate for Payer: Meridian Medicaid |
$53.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.46
|
| Rate for Payer: PACE SWMI |
$81.39
|
| Rate for Payer: PHP Medicare Advantage |
$81.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.03
|
| Rate for Payer: Priority Health Medicare |
$81.39
|
| Rate for Payer: Priority Health Narrow Network |
$137.03
|
| Rate for Payer: UHC Medicare Advantage |
$83.83
|
|
|
PR PYELOPLASTY COMPLICATED
|
Professional
|
Both
|
$2,616.00
|
|
|
Service Code
|
HCPCS 50405
|
| Min. Negotiated Rate |
$882.46 |
| Max. Negotiated Rate |
$2,215.47 |
| Rate for Payer: Aetna Commercial |
$1,823.73
|
| Rate for Payer: Aetna Medicare |
$1,360.99
|
| Rate for Payer: BCBS Complete |
$926.58
|
| Rate for Payer: BCBS MAPPO |
$1,360.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,085.73
|
| Rate for Payer: BCN Commercial |
$2,003.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,360.99
|
| Rate for Payer: Cash Price |
$2,092.80
|
| Rate for Payer: Cash Price |
$2,092.80
|
| Rate for Payer: Cofinity Commercial |
$1,959.83
|
| Rate for Payer: Cofinity Commercial |
$1,823.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,360.99
|
| Rate for Payer: Healthscope Commercial |
$1,633.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,633.19
|
| Rate for Payer: Meridian Medicaid |
$926.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,429.04
|
| Rate for Payer: PACE SWMI |
$1,360.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,360.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$882.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,831.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,215.47
|
| Rate for Payer: Priority Health Medicare |
$1,360.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,215.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,401.82
|
|
|
PR PYELOPLASTY SIMPLE
|
Professional
|
Both
|
$1,760.00
|
|
|
Service Code
|
HCPCS 50400
|
| Min. Negotiated Rate |
$731.66 |
| Max. Negotiated Rate |
$2,368.90 |
| Rate for Payer: Aetna Commercial |
$1,509.68
|
| Rate for Payer: Aetna Medicare |
$1,126.63
|
| Rate for Payer: BCBS Complete |
$768.24
|
| Rate for Payer: BCBS MAPPO |
$1,126.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,368.90
|
| Rate for Payer: BCN Commercial |
$1,659.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,126.63
|
| Rate for Payer: Cash Price |
$1,408.00
|
| Rate for Payer: Cash Price |
$1,408.00
|
| Rate for Payer: Cofinity Commercial |
$1,509.68
|
| Rate for Payer: Cofinity Commercial |
$1,622.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,126.63
|
| Rate for Payer: Healthscope Commercial |
$1,351.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,351.96
|
| Rate for Payer: Meridian Medicaid |
$768.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,182.96
|
| Rate for Payer: PACE SWMI |
$1,126.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,126.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$731.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,835.06
|
| Rate for Payer: Priority Health Medicare |
$1,126.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,835.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,160.43
|
|
|
PR PYLOROMYOTOMY CUTTING PYLORIC MUSC
|
Professional
|
Both
|
$2,212.00
|
|
|
Service Code
|
HCPCS 43520
|
| Min. Negotiated Rate |
$443.04 |
| Max. Negotiated Rate |
$1,548.40 |
| Rate for Payer: Aetna Commercial |
$917.43
|
| Rate for Payer: Aetna Medicare |
$684.65
|
| Rate for Payer: BCBS Complete |
$465.19
|
| Rate for Payer: BCBS MAPPO |
$684.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.39
|
| Rate for Payer: BCN Commercial |
$1,007.65
|
| Rate for Payer: BCN Medicare Advantage |
$684.65
|
| Rate for Payer: Cash Price |
$1,769.60
|
| Rate for Payer: Cash Price |
$1,769.60
|
| Rate for Payer: Cofinity Commercial |
$985.90
|
| Rate for Payer: Cofinity Commercial |
$917.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.65
|
| Rate for Payer: Healthscope Commercial |
$821.58
|
| Rate for Payer: Healthscope Whirlpool |
$821.58
|
| Rate for Payer: Meridian Medicaid |
$465.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$718.88
|
| Rate for Payer: PACE SWMI |
$684.65
|
| Rate for Payer: PHP Medicare Advantage |
$684.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,548.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,212.39
|
| Rate for Payer: Priority Health Medicare |
$684.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,212.39
|
| Rate for Payer: UHC Medicare Advantage |
$705.19
|
|
|
PR PYLOROPLASTY
|
Professional
|
Both
|
$2,507.00
|
|
|
Service Code
|
HCPCS 43800
|
| Min. Negotiated Rate |
$595.34 |
| Max. Negotiated Rate |
$1,754.90 |
| Rate for Payer: Aetna Commercial |
$1,239.38
|
| Rate for Payer: Aetna Medicare |
$924.91
|
| Rate for Payer: BCBS Complete |
$625.11
|
| Rate for Payer: BCBS MAPPO |
$924.91
|
| Rate for Payer: BCBS Trust/PPO |
$665.13
|
| Rate for Payer: BCN Commercial |
$1,357.06
|
| Rate for Payer: BCN Medicare Advantage |
$924.91
|
| Rate for Payer: Cash Price |
$2,005.60
|
| Rate for Payer: Cash Price |
$2,005.60
|
| Rate for Payer: Cofinity Commercial |
$1,239.38
|
| Rate for Payer: Cofinity Commercial |
$1,331.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$924.91
|
| Rate for Payer: Healthscope Commercial |
$1,109.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,109.89
|
| Rate for Payer: Meridian Medicaid |
$625.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$971.16
|
| Rate for Payer: PACE SWMI |
$924.91
|
| Rate for Payer: PHP Medicare Advantage |
$924.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,754.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,632.80
|
| Rate for Payer: Priority Health Medicare |
$924.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,632.80
|
| Rate for Payer: UHC Medicare Advantage |
$952.66
|
|
|
PR QNHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 98971
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$529.88 |
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna Medicare |
$19.60
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCBS MAPPO |
$19.60
|
| Rate for Payer: BCBS Trust/PPO |
$529.88
|
| Rate for Payer: BCN Commercial |
$29.32
|
| Rate for Payer: BCN Medicare Advantage |
$19.60
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$28.22
|
| Rate for Payer: Cofinity Commercial |
$26.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.60
|
| Rate for Payer: Healthscope Commercial |
$23.52
|
| Rate for Payer: Healthscope Whirlpool |
$23.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.58
|
| Rate for Payer: PACE SWMI |
$19.60
|
| Rate for Payer: PHP Medicare Advantage |
$19.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.49
|
| Rate for Payer: Priority Health Medicare |
$19.60
|
| Rate for Payer: Priority Health Narrow Network |
$26.49
|
| Rate for Payer: UHC Medicare Advantage |
$20.19
|
|
|
PR QNHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 98972
|
| Min. Negotiated Rate |
$30.29 |
| Max. Negotiated Rate |
$800.90 |
| Rate for Payer: Aetna Commercial |
$40.59
|
| Rate for Payer: Aetna Medicare |
$30.29
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: BCBS MAPPO |
$30.29
|
| Rate for Payer: BCBS Trust/PPO |
$800.90
|
| Rate for Payer: BCN Commercial |
$44.96
|
| Rate for Payer: BCN Medicare Advantage |
$30.29
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$43.62
|
| Rate for Payer: Cofinity Commercial |
$40.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.29
|
| Rate for Payer: Healthscope Commercial |
$36.35
|
| Rate for Payer: Healthscope Whirlpool |
$36.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.80
|
| Rate for Payer: PACE SWMI |
$30.29
|
| Rate for Payer: PHP Medicare Advantage |
$30.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.88
|
| Rate for Payer: Priority Health Medicare |
$30.29
|
| Rate for Payer: Priority Health Narrow Network |
$40.88
|
| Rate for Payer: UHC Medicare Advantage |
$31.20
|
|
|
PR QNHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 98970
|
| Min. Negotiated Rate |
$11.31 |
| Max. Negotiated Rate |
$131.55 |
| Rate for Payer: Aetna Commercial |
$15.16
|
| Rate for Payer: Aetna Medicare |
$11.31
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$11.31
|
| Rate for Payer: BCBS Trust/PPO |
$131.55
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: BCN Medicare Advantage |
$11.31
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$15.16
|
| Rate for Payer: Cofinity Commercial |
$16.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.31
|
| Rate for Payer: Healthscope Commercial |
$13.57
|
| Rate for Payer: Healthscope Whirlpool |
$13.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.88
|
| Rate for Payer: PACE SWMI |
$11.31
|
| Rate for Payer: PHP Medicare Advantage |
$11.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.27
|
| Rate for Payer: Priority Health Medicare |
$11.31
|
| Rate for Payer: Priority Health Narrow Network |
$15.27
|
| Rate for Payer: UHC Medicare Advantage |
$11.65
|
|
|
PR QUADRICEPSPLASTY
|
Professional
|
Both
|
$2,009.00
|
|
|
Service Code
|
HCPCS 27430
|
| Min. Negotiated Rate |
$481.17 |
| Max. Negotiated Rate |
$1,406.30 |
| Rate for Payer: Aetna Commercial |
$982.07
|
| Rate for Payer: Aetna Medicare |
$732.89
|
| Rate for Payer: BCBS Complete |
$505.23
|
| Rate for Payer: BCBS MAPPO |
$732.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.92
|
| Rate for Payer: BCN Commercial |
$1,093.66
|
| Rate for Payer: BCN Medicare Advantage |
$732.89
|
| Rate for Payer: Cash Price |
$1,607.20
|
| Rate for Payer: Cash Price |
$1,607.20
|
| Rate for Payer: Cofinity Commercial |
$982.07
|
| Rate for Payer: Cofinity Commercial |
$1,055.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.89
|
| Rate for Payer: Healthscope Commercial |
$879.47
|
| Rate for Payer: Healthscope Whirlpool |
$879.47
|
| Rate for Payer: Meridian Medicaid |
$505.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$769.53
|
| Rate for Payer: PACE SWMI |
$732.89
|
| Rate for Payer: PHP Medicare Advantage |
$732.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,406.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,142.84
|
| Rate for Payer: Priority Health Medicare |
$732.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,142.84
|
| Rate for Payer: UHC Medicare Advantage |
$754.88
|
|
|
PR QUAL NONMD EST PT 11-20M
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS G2062
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$24.64 |
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.64
|
| Rate for Payer: Priority Health Narrow Network |
$24.64
|
|
|
PR QUAL NONMD EST PT 21>MIN
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS G2063
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$38.19 |
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.19
|
| Rate for Payer: Priority Health Narrow Network |
$38.19
|
|
