|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93298
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$1,610.26 |
| Rate for Payer: Aetna Commercial |
$34.25
|
| Rate for Payer: Aetna Medicare |
$25.56
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$25.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.26
|
| Rate for Payer: BCN Commercial |
$37.63
|
| Rate for Payer: BCN Medicare Advantage |
$25.56
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$36.81
|
| Rate for Payer: Cofinity Commercial |
$34.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.56
|
| Rate for Payer: Healthscope Commercial |
$30.67
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.84
|
| Rate for Payer: PACE SWMI |
$25.56
|
| Rate for Payer: PHP Medicare Advantage |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.41
|
| Rate for Payer: Priority Health Medicare |
$25.56
|
| Rate for Payer: Priority Health Narrow Network |
$36.41
|
| Rate for Payer: UHC Medicare Advantage |
$26.33
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Professional
|
Both
|
$109.00
|
|
|
Service Code
|
HCPCS 99454
|
| Min. Negotiated Rate |
$43.60 |
| Max. Negotiated Rate |
$203.92 |
| Rate for Payer: Aetna Commercial |
$61.30
|
| Rate for Payer: Aetna Medicare |
$45.75
|
| Rate for Payer: BCBS Complete |
$43.60
|
| Rate for Payer: BCBS MAPPO |
$45.75
|
| Rate for Payer: BCBS Trust/PPO |
$203.92
|
| Rate for Payer: BCN Commercial |
$72.33
|
| Rate for Payer: BCN Medicare Advantage |
$45.75
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cofinity Commercial |
$61.30
|
| Rate for Payer: Cofinity Commercial |
$65.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.75
|
| Rate for Payer: Healthscope Commercial |
$50.32
|
| Rate for Payer: Healthscope Whirlpool |
$50.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.04
|
| Rate for Payer: PACE SWMI |
$45.75
|
| Rate for Payer: PHP Medicare Advantage |
$45.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.39
|
| Rate for Payer: Priority Health Medicare |
$45.75
|
| Rate for Payer: Priority Health Narrow Network |
$63.39
|
| Rate for Payer: UHC Medicare Advantage |
$47.12
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 99453
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$1,867.54 |
| Rate for Payer: Aetna Commercial |
$23.73
|
| Rate for Payer: Aetna Medicare |
$17.71
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$17.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,867.54
|
| Rate for Payer: BCN Commercial |
$27.85
|
| Rate for Payer: BCN Medicare Advantage |
$17.71
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$23.73
|
| Rate for Payer: Cofinity Commercial |
$25.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.71
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Healthscope Whirlpool |
$19.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.60
|
| Rate for Payer: PACE SWMI |
$17.71
|
| Rate for Payer: PHP Medicare Advantage |
$17.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.42
|
| Rate for Payer: Priority Health Medicare |
$17.71
|
| Rate for Payer: Priority Health Narrow Network |
$24.42
|
| Rate for Payer: UHC Medicare Advantage |
$18.24
|
|
|
PR REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 93264
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$817.28 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare |
$34.61
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS MAPPO |
$34.61
|
| Rate for Payer: BCBS Trust/PPO |
$817.28
|
| Rate for Payer: BCN Commercial |
$73.31
|
| Rate for Payer: BCN Medicare Advantage |
$34.61
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$49.84
|
| Rate for Payer: Cofinity Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.61
|
| Rate for Payer: Healthscope Commercial |
$41.53
|
| Rate for Payer: Healthscope Whirlpool |
$41.53
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.34
|
| Rate for Payer: PACE SWMI |
$34.61
|
| Rate for Payer: PHP Medicare Advantage |
$34.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.17
|
| Rate for Payer: Priority Health Medicare |
$34.61
|
| Rate for Payer: Priority Health Narrow Network |
$49.17
|
| Rate for Payer: UHC Medicare Advantage |
$35.65
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING 1ST 20 MIN MONTH
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS 99457
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$278.41 |
| Rate for Payer: Aetna Commercial |
$39.58
|
| Rate for Payer: Aetna Medicare |
$29.54
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCBS Trust/PPO |
$278.41
|
| Rate for Payer: BCN Commercial |
$70.37
|
| Rate for Payer: BCN Medicare Advantage |
$29.54
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.54
|
| Rate for Payer: Healthscope Commercial |
$32.49
|
| Rate for Payer: Healthscope Whirlpool |
$32.49
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.02
|
| Rate for Payer: PACE SWMI |
$29.54
|
| Rate for Payer: PHP Medicare Advantage |
$29.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.12
|
| Rate for Payer: Priority Health Medicare |
$29.54
|
| Rate for Payer: Priority Health Narrow Network |
$38.12
|
| Rate for Payer: UHC Medicare Advantage |
$30.43
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 99458
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$140.53 |
| Rate for Payer: Aetna Commercial |
$39.58
|
| Rate for Payer: Aetna Medicare |
$29.54
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCBS Trust/PPO |
$140.53
|
| Rate for Payer: BCN Commercial |
$57.17
|
| Rate for Payer: BCN Medicare Advantage |
$29.54
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.54
|
| Rate for Payer: Healthscope Commercial |
$32.49
|
| Rate for Payer: Healthscope Whirlpool |
$32.49
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.02
|
| Rate for Payer: PACE SWMI |
$29.54
|
| Rate for Payer: PHP Medicare Advantage |
$29.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.12
|
| Rate for Payer: Priority Health Medicare |
$29.54
|
| Rate for Payer: Priority Health Narrow Network |
$38.12
|
| Rate for Payer: UHC Medicare Advantage |
$30.43
|
|
|
PR REMOT IMAGE SUBMIT BY PT
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS G2010
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$11.97
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$119.40
|
| Rate for Payer: BCN Commercial |
$17.59
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$12.86
|
| Rate for Payer: Cofinity Commercial |
$11.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$10.72
|
| Rate for Payer: Healthscope Whirlpool |
$10.72
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.57
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$11.57
|
| Rate for Payer: UHC Medicare Advantage |
$9.20
|
|
|
PR REMOVAL ANAL SETON OTHER MARKER
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 46030
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$1,184.45 |
| Rate for Payer: Aetna Commercial |
$115.00
|
| Rate for Payer: Aetna Medicare |
$85.82
|
| Rate for Payer: BCBS Complete |
$94.40
|
| Rate for Payer: BCBS MAPPO |
$85.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.45
|
| Rate for Payer: BCN Commercial |
$377.75
|
| Rate for Payer: BCN Medicare Advantage |
$85.82
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$123.58
|
| Rate for Payer: Cofinity Commercial |
$115.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.82
|
| Rate for Payer: Healthscope Commercial |
$102.98
|
| Rate for Payer: Healthscope Whirlpool |
$102.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.11
|
| Rate for Payer: PACE SWMI |
$85.82
|
| Rate for Payer: PHP Medicare Advantage |
$85.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.29
|
| Rate for Payer: Priority Health Medicare |
$85.82
|
| Rate for Payer: Priority Health Narrow Network |
$152.29
|
| Rate for Payer: UHC Medicare Advantage |
$88.39
|
|
|
PR REMOVAL ANKLE IMPLANT
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 27704
|
| Min. Negotiated Rate |
$366.79 |
| Max. Negotiated Rate |
$2,348.82 |
| Rate for Payer: Aetna Commercial |
$748.58
|
| Rate for Payer: Aetna Medicare |
$558.64
|
| Rate for Payer: BCBS Complete |
$385.13
|
| Rate for Payer: BCBS MAPPO |
$558.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,348.82
|
| Rate for Payer: BCN Commercial |
$835.15
|
| Rate for Payer: BCN Medicare Advantage |
$558.64
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$804.44
|
| Rate for Payer: Cofinity Commercial |
$748.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.64
|
| Rate for Payer: Healthscope Commercial |
$670.37
|
| Rate for Payer: Healthscope Whirlpool |
$670.37
|
| Rate for Payer: Meridian Medicaid |
$385.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.57
|
| Rate for Payer: PACE SWMI |
$558.64
|
| Rate for Payer: PHP Medicare Advantage |
$558.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,250.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.70
|
| Rate for Payer: Priority Health Medicare |
$558.64
|
| Rate for Payer: Priority Health Narrow Network |
$872.70
|
| Rate for Payer: UHC Medicare Advantage |
$575.40
|
|
|
PR REMOVAL ANTERIOR INSTRUMENTATION
|
Professional
|
Both
|
$3,964.00
|
|
|
Service Code
|
HCPCS 22855
|
| Min. Negotiated Rate |
$210.26 |
| Max. Negotiated Rate |
$2,774.80 |
| Rate for Payer: Aetna Commercial |
$1,480.23
|
| Rate for Payer: Aetna Medicare |
$1,104.65
|
| Rate for Payer: BCBS Complete |
$751.92
|
| Rate for Payer: BCBS MAPPO |
$1,104.65
|
| Rate for Payer: BCBS Trust/PPO |
$210.26
|
| Rate for Payer: BCN Commercial |
$1,795.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,104.65
|
| Rate for Payer: Cash Price |
$3,171.20
|
| Rate for Payer: Cash Price |
$3,171.20
|
| Rate for Payer: Cofinity Commercial |
$1,480.23
|
| Rate for Payer: Cofinity Commercial |
$1,590.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,104.65
|
| Rate for Payer: Healthscope Commercial |
$1,325.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,325.58
|
| Rate for Payer: Meridian Medicaid |
$751.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,159.88
|
| Rate for Payer: PACE SWMI |
$1,104.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,104.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,774.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,703.53
|
| Rate for Payer: Priority Health Medicare |
$1,104.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,703.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,137.79
|
|
|
PR REMOVAL/BIVALVING FULL ARM/FULL LEG CAST
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 29705
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$1,732.82 |
| Rate for Payer: Aetna Commercial |
$58.99
|
| Rate for Payer: Aetna Medicare |
$44.02
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$44.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.82
|
| Rate for Payer: BCN Commercial |
$91.87
|
| Rate for Payer: BCN Medicare Advantage |
$44.02
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$58.99
|
| Rate for Payer: Cofinity Commercial |
$63.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.02
|
| Rate for Payer: Healthscope Commercial |
$52.82
|
| Rate for Payer: Healthscope Whirlpool |
$52.82
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.22
|
| Rate for Payer: PACE SWMI |
$44.02
|
| Rate for Payer: PHP Medicare Advantage |
$44.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.92
|
| Rate for Payer: Priority Health Medicare |
$44.02
|
| Rate for Payer: Priority Health Narrow Network |
$67.92
|
| Rate for Payer: UHC Medicare Advantage |
$45.34
|
|
|
PR REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA
|
Professional
|
Both
|
$363.00
|
|
|
Service Code
|
HCPCS 59871
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$714.79 |
| Rate for Payer: Aetna Commercial |
$178.13
|
| Rate for Payer: Aetna Medicare |
$132.93
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$132.93
|
| Rate for Payer: BCBS Trust/PPO |
$714.79
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: BCN Medicare Advantage |
$132.93
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cofinity Commercial |
$178.13
|
| Rate for Payer: Cofinity Commercial |
$191.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.93
|
| Rate for Payer: Healthscope Commercial |
$159.52
|
| Rate for Payer: Healthscope Whirlpool |
$159.52
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$139.58
|
| Rate for Payer: PACE SWMI |
$132.93
|
| Rate for Payer: PHP Medicare Advantage |
$132.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.92
|
| Rate for Payer: Priority Health Medicare |
$132.93
|
| Rate for Payer: Priority Health Narrow Network |
$187.92
|
| Rate for Payer: UHC Medicare Advantage |
$136.92
|
|
|
PR REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE
|
Professional
|
Both
|
$1,519.00
|
|
|
Service Code
|
HCPCS 21029
|
| Min. Negotiated Rate |
$401.93 |
| Max. Negotiated Rate |
$3,995.58 |
| Rate for Payer: Aetna Commercial |
$813.88
|
| Rate for Payer: Aetna Medicare |
$607.37
|
| Rate for Payer: BCBS Complete |
$422.03
|
| Rate for Payer: BCBS MAPPO |
$607.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,995.58
|
| Rate for Payer: BCN Commercial |
$1,128.35
|
| Rate for Payer: BCN Medicare Advantage |
$607.37
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cofinity Commercial |
$874.61
|
| Rate for Payer: Cofinity Commercial |
$813.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.37
|
| Rate for Payer: Healthscope Commercial |
$728.84
|
| Rate for Payer: Healthscope Whirlpool |
$728.84
|
| Rate for Payer: Meridian Medicaid |
$422.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.74
|
| Rate for Payer: PACE SWMI |
$607.37
|
| Rate for Payer: PHP Medicare Advantage |
$607.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$401.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$951.34
|
| Rate for Payer: Priority Health Medicare |
$607.37
|
| Rate for Payer: Priority Health Narrow Network |
$951.34
|
| Rate for Payer: UHC Medicare Advantage |
$625.59
|
|
|
PR REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO
|
Professional
|
Both
|
$1,511.00
|
|
|
Service Code
|
HCPCS 64570
|
| Min. Negotiated Rate |
$427.92 |
| Max. Negotiated Rate |
$1,264.38 |
| Rate for Payer: Aetna Commercial |
$988.16
|
| Rate for Payer: Aetna Medicare |
$737.43
|
| Rate for Payer: BCBS Complete |
$505.45
|
| Rate for Payer: BCBS MAPPO |
$737.43
|
| Rate for Payer: BCBS Trust/PPO |
$427.92
|
| Rate for Payer: BCN Commercial |
$1,091.21
|
| Rate for Payer: BCN Medicare Advantage |
$737.43
|
| Rate for Payer: Cash Price |
$1,208.80
|
| Rate for Payer: Cash Price |
$1,208.80
|
| Rate for Payer: Cofinity Commercial |
$1,061.90
|
| Rate for Payer: Cofinity Commercial |
$988.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$737.43
|
| Rate for Payer: Healthscope Commercial |
$884.92
|
| Rate for Payer: Healthscope Whirlpool |
$884.92
|
| Rate for Payer: Meridian Medicaid |
$505.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$774.30
|
| Rate for Payer: PACE SWMI |
$737.43
|
| Rate for Payer: PHP Medicare Advantage |
$737.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,057.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,264.38
|
| Rate for Payer: Priority Health Medicare |
$737.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,264.38
|
| Rate for Payer: UHC Medicare Advantage |
$759.55
|
|
|
PR REMOVAL EMBEDDED FOREIGN BODY EYELID
|
Professional
|
Both
|
$471.00
|
|
|
Service Code
|
HCPCS 67938
|
| Min. Negotiated Rate |
$74.76 |
| Max. Negotiated Rate |
$1,699.01 |
| Rate for Payer: Aetna Commercial |
$150.70
|
| Rate for Payer: Aetna Medicare |
$112.46
|
| Rate for Payer: BCBS Complete |
$78.50
|
| Rate for Payer: BCBS MAPPO |
$112.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,699.01
|
| Rate for Payer: BCN Commercial |
$399.74
|
| Rate for Payer: BCN Medicare Advantage |
$112.46
|
| Rate for Payer: Cash Price |
$376.80
|
| Rate for Payer: Cash Price |
$376.80
|
| Rate for Payer: Cofinity Commercial |
$150.70
|
| Rate for Payer: Cofinity Commercial |
$161.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.46
|
| Rate for Payer: Healthscope Commercial |
$134.95
|
| Rate for Payer: Healthscope Whirlpool |
$134.95
|
| Rate for Payer: Meridian Medicaid |
$78.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.08
|
| Rate for Payer: PACE SWMI |
$112.46
|
| Rate for Payer: PHP Medicare Advantage |
$112.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.32
|
| Rate for Payer: Priority Health Medicare |
$112.46
|
| Rate for Payer: Priority Health Narrow Network |
$204.32
|
| Rate for Payer: UHC Medicare Advantage |
$115.83
|
|
|
PR REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
HCPCS 20694
|
| Min. Negotiated Rate |
$221.95 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$447.91
|
| Rate for Payer: Aetna Medicare |
$334.26
|
| Rate for Payer: BCBS Complete |
$233.05
|
| Rate for Payer: BCBS MAPPO |
$334.26
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$634.30
|
| Rate for Payer: BCN Medicare Advantage |
$334.26
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cofinity Commercial |
$447.91
|
| Rate for Payer: Cofinity Commercial |
$481.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.26
|
| Rate for Payer: Healthscope Commercial |
$401.11
|
| Rate for Payer: Healthscope Whirlpool |
$401.11
|
| Rate for Payer: Meridian Medicaid |
$233.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$350.97
|
| Rate for Payer: PACE SWMI |
$334.26
|
| Rate for Payer: PHP Medicare Advantage |
$334.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$654.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$524.44
|
| Rate for Payer: Priority Health Medicare |
$334.26
|
| Rate for Payer: Priority Health Narrow Network |
$524.44
|
| Rate for Payer: UHC Medicare Advantage |
$344.29
|
|
|
PR REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 65205
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$238.26 |
| Rate for Payer: Aetna Commercial |
$37.86
|
| Rate for Payer: Aetna Medicare |
$28.25
|
| Rate for Payer: BCBS Complete |
$19.24
|
| Rate for Payer: BCBS MAPPO |
$28.25
|
| Rate for Payer: BCBS Trust/PPO |
$238.26
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Medicare Advantage |
$28.25
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$40.68
|
| Rate for Payer: Cofinity Commercial |
$37.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.25
|
| Rate for Payer: Healthscope Commercial |
$33.90
|
| Rate for Payer: Healthscope Whirlpool |
$33.90
|
| Rate for Payer: Meridian Medicaid |
$19.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.66
|
| Rate for Payer: PACE SWMI |
$28.25
|
| Rate for Payer: PHP Medicare Advantage |
$28.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.34
|
| Rate for Payer: Priority Health Medicare |
$28.25
|
| Rate for Payer: Priority Health Narrow Network |
$50.34
|
| Rate for Payer: UHC Medicare Advantage |
$29.10
|
|
|
PR REMOVAL FOREIGN BODY DEEP PENILE TISSUE
|
Professional
|
Both
|
$833.00
|
|
|
Service Code
|
HCPCS 54115
|
| Min. Negotiated Rate |
$273.71 |
| Max. Negotiated Rate |
$2,119.54 |
| Rate for Payer: Aetna Commercial |
$556.70
|
| Rate for Payer: Aetna Medicare |
$415.45
|
| Rate for Payer: BCBS Complete |
$287.40
|
| Rate for Payer: BCBS MAPPO |
$415.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,119.54
|
| Rate for Payer: BCN Commercial |
$663.13
|
| Rate for Payer: BCN Medicare Advantage |
$415.45
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$598.25
|
| Rate for Payer: Cofinity Commercial |
$556.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.45
|
| Rate for Payer: Healthscope Commercial |
$498.54
|
| Rate for Payer: Healthscope Whirlpool |
$498.54
|
| Rate for Payer: Meridian Medicaid |
$287.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$436.22
|
| Rate for Payer: PACE SWMI |
$415.45
|
| Rate for Payer: PHP Medicare Advantage |
$415.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$682.48
|
| Rate for Payer: Priority Health Medicare |
$415.45
|
| Rate for Payer: Priority Health Narrow Network |
$682.48
|
| Rate for Payer: UHC Medicare Advantage |
$427.91
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
IP
|
$1,092.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$764.40 |
| Max. Negotiated Rate |
$1,092.00 |
| Rate for Payer: Aetna Commercial |
$982.80
|
| Rate for Payer: ASR ASR |
$1,059.24
|
| Rate for Payer: BCBS Trust/PPO |
$846.63
|
| Rate for Payer: BCN Commercial |
$846.63
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$1,026.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.60
|
| Rate for Payer: Healthscope Commercial |
$1,092.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,059.24
|
| Rate for Payer: Mclaren Commercial |
$982.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$928.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$960.96
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 27372
|
| Min. Negotiated Rate |
$259.65 |
| Max. Negotiated Rate |
$3,545.42 |
| Rate for Payer: Aetna Commercial |
$529.13
|
| Rate for Payer: Aetna Medicare |
$394.87
|
| Rate for Payer: BCBS Complete |
$272.63
|
| Rate for Payer: BCBS MAPPO |
$394.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,545.42
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$394.87
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$568.61
|
| Rate for Payer: Cofinity Commercial |
$529.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.87
|
| Rate for Payer: Healthscope Commercial |
$473.84
|
| Rate for Payer: Healthscope Whirlpool |
$473.84
|
| Rate for Payer: Meridian Medicaid |
$272.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$414.61
|
| Rate for Payer: PACE SWMI |
$394.87
|
| Rate for Payer: PHP Medicare Advantage |
$394.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$617.38
|
| Rate for Payer: Priority Health Medicare |
$394.87
|
| Rate for Payer: Priority Health Narrow Network |
$617.38
|
| Rate for Payer: UHC Medicare Advantage |
$406.72
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
OP
|
$1,092.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$764.40 |
| Max. Negotiated Rate |
$3,378.18 |
| Rate for Payer: Aetna Commercial |
$982.80
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: ASR ASR |
$1,059.24
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$846.63
|
| Rate for Payer: BCN Commercial |
$846.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$1,026.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,092.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,059.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$982.80
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$928.20
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,378.18
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,702.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$960.96
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 27372
|
| Hospital Charge Code |
27372
|
| Min. Negotiated Rate |
$259.65 |
| Max. Negotiated Rate |
$3,545.42 |
| Rate for Payer: Aetna Commercial |
$529.13
|
| Rate for Payer: Aetna Medicare |
$394.87
|
| Rate for Payer: BCBS Complete |
$272.63
|
| Rate for Payer: BCBS MAPPO |
$394.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,545.42
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$394.87
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$568.61
|
| Rate for Payer: Cofinity Commercial |
$529.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.87
|
| Rate for Payer: Healthscope Commercial |
$473.84
|
| Rate for Payer: Healthscope Whirlpool |
$473.84
|
| Rate for Payer: Meridian Medicaid |
$272.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$414.61
|
| Rate for Payer: PACE SWMI |
$394.87
|
| Rate for Payer: PHP Medicare Advantage |
$394.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$617.38
|
| Rate for Payer: Priority Health Medicare |
$394.87
|
| Rate for Payer: Priority Health Narrow Network |
$617.38
|
| Rate for Payer: UHC Medicare Advantage |
$406.72
|
|
|
PR REMOVAL FOREIGN BODY FOOT COMPLICATED
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 28193
|
| Min. Negotiated Rate |
$235.15 |
| Max. Negotiated Rate |
$1,271.09 |
| Rate for Payer: Aetna Commercial |
$478.15
|
| Rate for Payer: Aetna Medicare |
$356.83
|
| Rate for Payer: BCBS Complete |
$246.91
|
| Rate for Payer: BCBS MAPPO |
$356.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.09
|
| Rate for Payer: BCN Commercial |
$756.96
|
| Rate for Payer: BCN Medicare Advantage |
$356.83
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$478.15
|
| Rate for Payer: Cofinity Commercial |
$513.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.83
|
| Rate for Payer: Healthscope Commercial |
$428.20
|
| Rate for Payer: Healthscope Whirlpool |
$428.20
|
| Rate for Payer: Meridian Medicaid |
$246.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$374.67
|
| Rate for Payer: PACE SWMI |
$356.83
|
| Rate for Payer: PHP Medicare Advantage |
$356.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$556.10
|
| Rate for Payer: Priority Health Medicare |
$356.83
|
| Rate for Payer: Priority Health Narrow Network |
$556.10
|
| Rate for Payer: UHC Medicare Advantage |
$367.53
|
|
|
PR REMOVAL FOREIGN BODY FOOT DEEP
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 28192
|
| Min. Negotiated Rate |
$199.79 |
| Max. Negotiated Rate |
$1,065.05 |
| Rate for Payer: Aetna Commercial |
$404.44
|
| Rate for Payer: Aetna Medicare |
$301.82
|
| Rate for Payer: BCBS Complete |
$209.78
|
| Rate for Payer: BCBS MAPPO |
$301.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.05
|
| Rate for Payer: BCN Commercial |
$666.06
|
| Rate for Payer: BCN Medicare Advantage |
$301.82
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Commercial |
$434.62
|
| Rate for Payer: Cofinity Commercial |
$404.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.82
|
| Rate for Payer: Healthscope Commercial |
$362.18
|
| Rate for Payer: Healthscope Whirlpool |
$362.18
|
| Rate for Payer: Meridian Medicaid |
$209.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.91
|
| Rate for Payer: PACE SWMI |
$301.82
|
| Rate for Payer: PHP Medicare Advantage |
$301.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.33
|
| Rate for Payer: Priority Health Medicare |
$301.82
|
| Rate for Payer: Priority Health Narrow Network |
$471.33
|
| Rate for Payer: UHC Medicare Advantage |
$310.87
|
|
|
PR REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS
|
Professional
|
Both
|
$586.00
|
|
|
Service Code
|
HCPCS 28190
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$996.37 |
| Rate for Payer: Aetna Commercial |
$172.12
|
| Rate for Payer: Aetna Medicare |
$128.45
|
| Rate for Payer: BCBS Complete |
$89.46
|
| Rate for Payer: BCBS MAPPO |
$128.45
|
| Rate for Payer: BCBS Trust/PPO |
$996.37
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$128.45
|
| Rate for Payer: Cash Price |
$468.80
|
| Rate for Payer: Cash Price |
$468.80
|
| Rate for Payer: Cofinity Commercial |
$184.97
|
| Rate for Payer: Cofinity Commercial |
$172.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.45
|
| Rate for Payer: Healthscope Commercial |
$154.14
|
| Rate for Payer: Healthscope Whirlpool |
$154.14
|
| Rate for Payer: Meridian Medicaid |
$89.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.87
|
| Rate for Payer: PACE SWMI |
$128.45
|
| Rate for Payer: PHP Medicare Advantage |
$128.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.69
|
| Rate for Payer: Priority Health Medicare |
$128.45
|
| Rate for Payer: Priority Health Narrow Network |
$200.69
|
| Rate for Payer: UHC Medicare Advantage |
$132.30
|
|
