|
PR EXERCISE EQUIPMENT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS A9300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
|
|
PR EXISION OF SUBLINGUAL GLAND
|
Professional
|
Both
|
$790.00
|
|
|
Service Code
|
HCPCS 42450
|
| Min. Negotiated Rate |
$210.02 |
| Max. Negotiated Rate |
$673.51 |
| Rate for Payer: Aetna Commercial |
$427.29
|
| Rate for Payer: Aetna Medicare |
$318.87
|
| Rate for Payer: BCBS Complete |
$220.52
|
| Rate for Payer: BCBS MAPPO |
$318.87
|
| Rate for Payer: BCN Commercial |
$552.76
|
| Rate for Payer: BCN Medicare Advantage |
$318.87
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$427.29
|
| Rate for Payer: Cofinity Commercial |
$459.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.87
|
| Rate for Payer: Healthscope Commercial |
$382.64
|
| Rate for Payer: Healthscope Whirlpool |
$382.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.81
|
| Rate for Payer: Meridian Medicaid |
$220.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$350.76
|
| Rate for Payer: Nomi Health Commercial |
$382.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$592.50
|
| Rate for Payer: PACE SWMI |
$318.87
|
| Rate for Payer: PHP Medicare Advantage |
$318.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$673.51
|
| Rate for Payer: Priority Health Medicare |
$318.87
|
| Rate for Payer: Priority Health Narrow Network |
$673.51
|
| Rate for Payer: Railroad Medicare Medicare |
$318.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$318.87
|
| Rate for Payer: UHC Exchange |
$620.45
|
| Rate for Payer: UHC Medicaid |
$210.02
|
| Rate for Payer: UHCCP DNSP |
$318.87
|
| Rate for Payer: UHCCP Medicaid |
$210.02
|
|
|
PR EXPL CONGENITAL ATRESIA BILE DUCTS
|
Professional
|
Both
|
$2,989.00
|
|
|
Service Code
|
HCPCS 47700
|
| Min. Negotiated Rate |
$643.05 |
| Max. Negotiated Rate |
$2,241.75 |
| Rate for Payer: Aetna Commercial |
$1,337.88
|
| Rate for Payer: Aetna Medicare |
$998.42
|
| Rate for Payer: BCBS Complete |
$675.20
|
| Rate for Payer: BCBS MAPPO |
$998.42
|
| Rate for Payer: BCN Commercial |
$1,594.03
|
| Rate for Payer: BCN Medicare Advantage |
$998.42
|
| Rate for Payer: Cash Price |
$2,391.20
|
| Rate for Payer: Cash Price |
$2,391.20
|
| Rate for Payer: Cofinity Commercial |
$1,437.72
|
| Rate for Payer: Cofinity Commercial |
$1,337.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$998.42
|
| Rate for Payer: Healthscope Commercial |
$1,198.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,198.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,048.34
|
| Rate for Payer: Meridian Medicaid |
$675.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,098.26
|
| Rate for Payer: Nomi Health Commercial |
$1,198.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,241.75
|
| Rate for Payer: PACE SWMI |
$998.42
|
| Rate for Payer: PHP Medicare Advantage |
$998.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,942.23
|
| Rate for Payer: Priority Health Medicare |
$998.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,942.23
|
| Rate for Payer: Railroad Medicare Medicare |
$998.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,879.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$998.42
|
| Rate for Payer: UHC Exchange |
$1,879.46
|
| Rate for Payer: UHC Medicaid |
$643.05
|
| Rate for Payer: UHCCP DNSP |
$998.42
|
| Rate for Payer: UHCCP Medicaid |
$643.05
|
|
|
PR EXPLORATION EPIDIDYMIS W/WO BIOPSY
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 54865
|
| Min. Negotiated Rate |
$214.28 |
| Max. Negotiated Rate |
$627.72 |
| Rate for Payer: Aetna Commercial |
$439.96
|
| Rate for Payer: Aetna Medicare |
$328.33
|
| Rate for Payer: BCBS Complete |
$224.99
|
| Rate for Payer: BCBS MAPPO |
$328.33
|
| Rate for Payer: BCN Commercial |
$545.29
|
| Rate for Payer: BCN Medicare Advantage |
$328.33
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cofinity Commercial |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$439.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.33
|
| Rate for Payer: Healthscope Commercial |
$394.00
|
| Rate for Payer: Healthscope Whirlpool |
$394.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.75
|
| Rate for Payer: Meridian Medicaid |
$224.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$361.16
|
| Rate for Payer: Nomi Health Commercial |
$394.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$519.75
|
| Rate for Payer: PACE SWMI |
$328.33
|
| Rate for Payer: PHP Medicare Advantage |
$328.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$593.99
|
| Rate for Payer: Priority Health Medicare |
$328.33
|
| Rate for Payer: Priority Health Narrow Network |
$593.99
|
| Rate for Payer: Railroad Medicare Medicare |
$328.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$627.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$328.33
|
| Rate for Payer: UHC Exchange |
$627.72
|
| Rate for Payer: UHC Medicaid |
$214.28
|
| Rate for Payer: UHCCP DNSP |
$328.33
|
| Rate for Payer: UHCCP Medicaid |
$214.28
|
|
|
PR EXPLORATION, FEMORAL ARTERY
|
Professional
|
Both
|
$1,610.00
|
|
|
Service Code
|
HCPCS 35721
|
| Min. Negotiated Rate |
$644.00 |
| Max. Negotiated Rate |
$1,207.50 |
| Rate for Payer: BCBS Complete |
$644.00
|
| Rate for Payer: Cash Price |
$1,288.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,207.50
|
|
|
PR EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY
|
Professional
|
Both
|
$897.00
|
|
|
Service Code
|
HCPCS 35703
|
| Min. Negotiated Rate |
$242.18 |
| Max. Negotiated Rate |
$743.10 |
| Rate for Payer: Aetna Commercial |
$510.10
|
| Rate for Payer: Aetna Medicare |
$380.67
|
| Rate for Payer: BCBS Complete |
$254.29
|
| Rate for Payer: BCBS MAPPO |
$380.67
|
| Rate for Payer: BCN Commercial |
$615.50
|
| Rate for Payer: BCN Medicare Advantage |
$380.67
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cofinity Commercial |
$510.10
|
| Rate for Payer: Cofinity Commercial |
$548.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.67
|
| Rate for Payer: Healthscope Commercial |
$456.80
|
| Rate for Payer: Healthscope Whirlpool |
$456.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.70
|
| Rate for Payer: Meridian Medicaid |
$254.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.74
|
| Rate for Payer: Nomi Health Commercial |
$456.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$672.75
|
| Rate for Payer: PACE SWMI |
$380.67
|
| Rate for Payer: PHP Medicare Advantage |
$380.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$661.89
|
| Rate for Payer: Priority Health Medicare |
$380.67
|
| Rate for Payer: Priority Health Narrow Network |
$661.89
|
| Rate for Payer: Railroad Medicare Medicare |
$380.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$743.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.67
|
| Rate for Payer: UHC Exchange |
$743.10
|
| Rate for Payer: UHC Medicaid |
$242.18
|
| Rate for Payer: UHCCP DNSP |
$380.67
|
| Rate for Payer: UHCCP Medicaid |
$242.18
|
|
|
PR EXPLORATION N/FLWD SURG NECK ARTERY
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
HCPCS 35701
|
| Min. Negotiated Rate |
$244.52 |
| Max. Negotiated Rate |
$774.04 |
| Rate for Payer: Aetna Commercial |
$510.14
|
| Rate for Payer: Aetna Medicare |
$380.70
|
| Rate for Payer: BCBS Complete |
$256.75
|
| Rate for Payer: BCBS MAPPO |
$380.70
|
| Rate for Payer: BCN Commercial |
$652.85
|
| Rate for Payer: BCN Medicare Advantage |
$380.70
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cofinity Commercial |
$548.21
|
| Rate for Payer: Cofinity Commercial |
$510.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.70
|
| Rate for Payer: Healthscope Commercial |
$456.84
|
| Rate for Payer: Healthscope Whirlpool |
$456.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.74
|
| Rate for Payer: Meridian Medicaid |
$256.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.77
|
| Rate for Payer: Nomi Health Commercial |
$456.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$701.25
|
| Rate for Payer: PACE SWMI |
$380.70
|
| Rate for Payer: PHP Medicare Advantage |
$380.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$702.06
|
| Rate for Payer: Priority Health Medicare |
$380.70
|
| Rate for Payer: Priority Health Narrow Network |
$702.06
|
| Rate for Payer: Railroad Medicare Medicare |
$380.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$774.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.70
|
| Rate for Payer: UHC Exchange |
$774.04
|
| Rate for Payer: UHC Medicaid |
$244.52
|
| Rate for Payer: UHCCP DNSP |
$380.70
|
| Rate for Payer: UHCCP Medicaid |
$244.52
|
|
|
PR EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY
|
Professional
|
Both
|
$932.00
|
|
|
Service Code
|
HCPCS 35702
|
| Min. Negotiated Rate |
$237.28 |
| Max. Negotiated Rate |
$729.93 |
| Rate for Payer: Aetna Commercial |
$498.20
|
| Rate for Payer: Aetna Medicare |
$371.79
|
| Rate for Payer: BCBS Complete |
$249.14
|
| Rate for Payer: BCBS MAPPO |
$371.79
|
| Rate for Payer: BCN Commercial |
$606.54
|
| Rate for Payer: BCN Medicare Advantage |
$371.79
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cofinity Commercial |
$535.38
|
| Rate for Payer: Cofinity Commercial |
$498.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.79
|
| Rate for Payer: Healthscope Commercial |
$446.15
|
| Rate for Payer: Healthscope Whirlpool |
$446.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.38
|
| Rate for Payer: Meridian Medicaid |
$249.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$408.97
|
| Rate for Payer: Nomi Health Commercial |
$446.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$699.00
|
| Rate for Payer: PACE SWMI |
$371.79
|
| Rate for Payer: PHP Medicare Advantage |
$371.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$652.26
|
| Rate for Payer: Priority Health Medicare |
$371.79
|
| Rate for Payer: Priority Health Narrow Network |
$652.26
|
| Rate for Payer: Railroad Medicare Medicare |
$371.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$729.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.79
|
| Rate for Payer: UHC Exchange |
$729.93
|
| Rate for Payer: UHC Medicaid |
$237.28
|
| Rate for Payer: UHCCP DNSP |
$371.79
|
| Rate for Payer: UHCCP Medicaid |
$237.28
|
|
|
PR EXPLORATION OF ARTERY/VEIN
|
Professional
|
Both
|
$1,347.00
|
|
|
Service Code
|
HCPCS 35761
|
| Min. Negotiated Rate |
$538.80 |
| Max. Negotiated Rate |
$1,010.25 |
| Rate for Payer: BCBS Complete |
$538.80
|
| Rate for Payer: Cash Price |
$1,077.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,010.25
|
|
|
PR EXPLORATION PENETRATING WOUND SPX CHEST
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 20101
|
| Min. Negotiated Rate |
$128.65 |
| Max. Negotiated Rate |
$886.50 |
| Rate for Payer: Aetna Commercial |
$267.20
|
| Rate for Payer: Aetna Medicare |
$199.40
|
| Rate for Payer: BCBS Complete |
$135.08
|
| Rate for Payer: BCBS MAPPO |
$199.40
|
| Rate for Payer: BCN Commercial |
$315.23
|
| Rate for Payer: BCN Medicare Advantage |
$199.40
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$267.20
|
| Rate for Payer: Cofinity Commercial |
$287.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.40
|
| Rate for Payer: Healthscope Commercial |
$239.28
|
| Rate for Payer: Healthscope Whirlpool |
$239.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.37
|
| Rate for Payer: Meridian Medicaid |
$135.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.34
|
| Rate for Payer: Nomi Health Commercial |
$239.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$886.50
|
| Rate for Payer: PACE SWMI |
$199.40
|
| Rate for Payer: PHP Medicare Advantage |
$199.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$336.96
|
| Rate for Payer: Priority Health Medicare |
$199.40
|
| Rate for Payer: Priority Health Narrow Network |
$336.96
|
| Rate for Payer: Railroad Medicare Medicare |
$199.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$371.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.40
|
| Rate for Payer: UHC Exchange |
$371.91
|
| Rate for Payer: UHC Medicaid |
$128.65
|
| Rate for Payer: UHCCP DNSP |
$199.40
|
| Rate for Payer: UHCCP Medicaid |
$128.65
|
|
|
PR EXPLORATION PENETRATING WOUND SPX EXTREMITY
|
Professional
|
Both
|
$1,872.00
|
|
|
Service Code
|
HCPCS 20103
|
| Min. Negotiated Rate |
$201.92 |
| Max. Negotiated Rate |
$1,404.00 |
| Rate for Payer: Aetna Commercial |
$417.62
|
| Rate for Payer: Aetna Medicare |
$311.66
|
| Rate for Payer: BCBS Complete |
$212.02
|
| Rate for Payer: BCBS MAPPO |
$311.66
|
| Rate for Payer: BCN Commercial |
$518.90
|
| Rate for Payer: BCN Medicare Advantage |
$311.66
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cofinity Commercial |
$448.79
|
| Rate for Payer: Cofinity Commercial |
$417.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.66
|
| Rate for Payer: Healthscope Commercial |
$373.99
|
| Rate for Payer: Healthscope Whirlpool |
$373.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.24
|
| Rate for Payer: Meridian Medicaid |
$212.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.83
|
| Rate for Payer: Nomi Health Commercial |
$373.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,404.00
|
| Rate for Payer: PACE SWMI |
$311.66
|
| Rate for Payer: PHP Medicare Advantage |
$311.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$554.68
|
| Rate for Payer: Priority Health Medicare |
$311.66
|
| Rate for Payer: Priority Health Narrow Network |
$554.68
|
| Rate for Payer: Railroad Medicare Medicare |
$311.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$608.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$311.66
|
| Rate for Payer: UHC Exchange |
$608.72
|
| Rate for Payer: UHC Medicaid |
$201.92
|
| Rate for Payer: UHCCP DNSP |
$311.66
|
| Rate for Payer: UHCCP Medicaid |
$201.92
|
|
|
PR EXPLORATION PENETRATING WOUND SPX NECK
|
Professional
|
Both
|
$1,997.00
|
|
|
Service Code
|
HCPCS 20100
|
| Min. Negotiated Rate |
$348.04 |
| Max. Negotiated Rate |
$1,497.75 |
| Rate for Payer: Aetna Commercial |
$728.57
|
| Rate for Payer: Aetna Medicare |
$543.71
|
| Rate for Payer: BCBS Complete |
$365.44
|
| Rate for Payer: BCBS MAPPO |
$543.71
|
| Rate for Payer: BCN Commercial |
$899.85
|
| Rate for Payer: BCN Medicare Advantage |
$543.71
|
| Rate for Payer: Cash Price |
$1,597.60
|
| Rate for Payer: Cash Price |
$1,597.60
|
| Rate for Payer: Cofinity Commercial |
$782.94
|
| Rate for Payer: Cofinity Commercial |
$728.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.71
|
| Rate for Payer: Healthscope Commercial |
$652.45
|
| Rate for Payer: Healthscope Whirlpool |
$652.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.90
|
| Rate for Payer: Meridian Medicaid |
$365.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.08
|
| Rate for Payer: Nomi Health Commercial |
$652.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,497.75
|
| Rate for Payer: PACE SWMI |
$543.71
|
| Rate for Payer: PHP Medicare Advantage |
$543.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$961.91
|
| Rate for Payer: Priority Health Medicare |
$543.71
|
| Rate for Payer: Priority Health Narrow Network |
$961.91
|
| Rate for Payer: Railroad Medicare Medicare |
$543.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,070.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$543.71
|
| Rate for Payer: UHC Exchange |
$1,070.07
|
| Rate for Payer: UHC Medicaid |
$348.04
|
| Rate for Payer: UHCCP DNSP |
$543.71
|
| Rate for Payer: UHCCP Medicaid |
$348.04
|
|
|
PR EXPLORATION POPLITEAL ARTERY
|
Professional
|
Both
|
$1,111.00
|
|
|
Service Code
|
HCPCS 35741
|
| Min. Negotiated Rate |
$444.40 |
| Max. Negotiated Rate |
$833.25 |
| Rate for Payer: BCBS Complete |
$444.40
|
| Rate for Payer: Cash Price |
$888.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$833.25
|
|
|
PR EXPLORATION SPINAL FUSION
|
Professional
|
Both
|
$5,330.00
|
|
|
Service Code
|
HCPCS 22830
|
| Min. Negotiated Rate |
$504.81 |
| Max. Negotiated Rate |
$3,997.50 |
| Rate for Payer: Aetna Commercial |
$1,043.35
|
| Rate for Payer: Aetna Medicare |
$778.62
|
| Rate for Payer: BCBS Complete |
$530.05
|
| Rate for Payer: BCBS MAPPO |
$778.62
|
| Rate for Payer: BCN Commercial |
$1,255.41
|
| Rate for Payer: BCN Medicare Advantage |
$778.62
|
| Rate for Payer: Cash Price |
$4,264.00
|
| Rate for Payer: Cash Price |
$4,264.00
|
| Rate for Payer: Cofinity Commercial |
$1,043.35
|
| Rate for Payer: Cofinity Commercial |
$1,121.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$778.62
|
| Rate for Payer: Healthscope Commercial |
$934.34
|
| Rate for Payer: Healthscope Whirlpool |
$934.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$817.55
|
| Rate for Payer: Meridian Medicaid |
$530.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$856.48
|
| Rate for Payer: Nomi Health Commercial |
$934.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,997.50
|
| Rate for Payer: PACE SWMI |
$778.62
|
| Rate for Payer: PHP Medicare Advantage |
$778.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,342.01
|
| Rate for Payer: Priority Health Medicare |
$778.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,342.01
|
| Rate for Payer: Railroad Medicare Medicare |
$778.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,434.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$778.62
|
| Rate for Payer: UHC Exchange |
$1,434.98
|
| Rate for Payer: UHC Medicaid |
$504.81
|
| Rate for Payer: UHCCP DNSP |
$778.62
|
| Rate for Payer: UHCCP Medicaid |
$504.81
|
|
|
PR EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX
|
Professional
|
Both
|
$2,424.00
|
|
|
Service Code
|
HCPCS 49000
|
| Min. Negotiated Rate |
$464.77 |
| Max. Negotiated Rate |
$1,818.00 |
| Rate for Payer: Aetna Commercial |
$968.36
|
| Rate for Payer: Aetna Medicare |
$722.66
|
| Rate for Payer: BCBS Complete |
$488.01
|
| Rate for Payer: BCBS MAPPO |
$722.66
|
| Rate for Payer: BCN Commercial |
$1,158.31
|
| Rate for Payer: BCN Medicare Advantage |
$722.66
|
| Rate for Payer: Cash Price |
$1,939.20
|
| Rate for Payer: Cash Price |
$1,939.20
|
| Rate for Payer: Cofinity Commercial |
$968.36
|
| Rate for Payer: Cofinity Commercial |
$1,040.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.66
|
| Rate for Payer: Healthscope Commercial |
$867.19
|
| Rate for Payer: Healthscope Whirlpool |
$867.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.79
|
| Rate for Payer: Meridian Medicaid |
$488.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$794.93
|
| Rate for Payer: Nomi Health Commercial |
$867.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,818.00
|
| Rate for Payer: PACE SWMI |
$722.66
|
| Rate for Payer: PHP Medicare Advantage |
$722.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,411.32
|
| Rate for Payer: Priority Health Medicare |
$722.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,411.32
|
| Rate for Payer: Railroad Medicare Medicare |
$722.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,367.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$722.66
|
| Rate for Payer: UHC Exchange |
$1,367.78
|
| Rate for Payer: UHC Medicaid |
$464.77
|
| Rate for Payer: UHCCP DNSP |
$722.66
|
| Rate for Payer: UHCCP Medicaid |
$464.77
|
|
|
PR EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK
|
Professional
|
Both
|
$2,095.00
|
|
|
Service Code
|
HCPCS 20102
|
| Min. Negotiated Rate |
$156.34 |
| Max. Negotiated Rate |
$1,571.25 |
| Rate for Payer: Aetna Commercial |
$324.62
|
| Rate for Payer: Aetna Medicare |
$242.25
|
| Rate for Payer: BCBS Complete |
$164.16
|
| Rate for Payer: BCBS MAPPO |
$242.25
|
| Rate for Payer: BCN Commercial |
$385.44
|
| Rate for Payer: BCN Medicare Advantage |
$242.25
|
| Rate for Payer: Cash Price |
$1,676.00
|
| Rate for Payer: Cash Price |
$1,676.00
|
| Rate for Payer: Cofinity Commercial |
$348.84
|
| Rate for Payer: Cofinity Commercial |
$324.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.25
|
| Rate for Payer: Healthscope Commercial |
$290.70
|
| Rate for Payer: Healthscope Whirlpool |
$290.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.36
|
| Rate for Payer: Meridian Medicaid |
$164.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$266.48
|
| Rate for Payer: Nomi Health Commercial |
$290.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,571.25
|
| Rate for Payer: PACE SWMI |
$242.25
|
| Rate for Payer: PHP Medicare Advantage |
$242.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$412.02
|
| Rate for Payer: Priority Health Medicare |
$242.25
|
| Rate for Payer: Priority Health Narrow Network |
$412.02
|
| Rate for Payer: Railroad Medicare Medicare |
$242.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$452.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$242.25
|
| Rate for Payer: UHC Exchange |
$452.90
|
| Rate for Payer: UHC Medicaid |
$156.34
|
| Rate for Payer: UHCCP DNSP |
$242.25
|
| Rate for Payer: UHCCP Medicaid |
$156.34
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD
|
Professional
|
Both
|
$2,424.00
|
|
|
Service Code
|
HCPCS 35840
|
| Min. Negotiated Rate |
$716.32 |
| Max. Negotiated Rate |
$2,138.70 |
| Rate for Payer: Aetna Commercial |
$1,501.54
|
| Rate for Payer: Aetna Medicare |
$1,120.55
|
| Rate for Payer: BCBS Complete |
$752.14
|
| Rate for Payer: BCBS MAPPO |
$1,120.55
|
| Rate for Payer: BCN Commercial |
$1,817.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,120.55
|
| Rate for Payer: Cash Price |
$1,939.20
|
| Rate for Payer: Cash Price |
$1,939.20
|
| Rate for Payer: Cofinity Commercial |
$1,613.59
|
| Rate for Payer: Cofinity Commercial |
$1,501.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,120.55
|
| Rate for Payer: Healthscope Commercial |
$1,344.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,344.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,176.58
|
| Rate for Payer: Meridian Medicaid |
$752.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,232.61
|
| Rate for Payer: Nomi Health Commercial |
$1,344.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,818.00
|
| Rate for Payer: PACE SWMI |
$1,120.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,120.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,954.64
|
| Rate for Payer: Priority Health Medicare |
$1,120.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,954.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,120.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,138.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,120.55
|
| Rate for Payer: UHC Exchange |
$2,138.70
|
| Rate for Payer: UHC Medicaid |
$716.32
|
| Rate for Payer: UHCCP DNSP |
$1,120.55
|
| Rate for Payer: UHCCP Medicaid |
$716.32
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ CH
|
Professional
|
Both
|
$5,759.00
|
|
|
Service Code
|
HCPCS 35820
|
| Min. Negotiated Rate |
$1,193.01 |
| Max. Negotiated Rate |
$4,319.25 |
| Rate for Payer: Aetna Commercial |
$2,514.08
|
| Rate for Payer: Aetna Medicare |
$1,876.18
|
| Rate for Payer: BCBS Complete |
$1,252.66
|
| Rate for Payer: BCBS MAPPO |
$1,876.18
|
| Rate for Payer: BCN Commercial |
$2,962.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,876.18
|
| Rate for Payer: Cash Price |
$4,607.20
|
| Rate for Payer: Cash Price |
$4,607.20
|
| Rate for Payer: Cofinity Commercial |
$2,701.70
|
| Rate for Payer: Cofinity Commercial |
$2,514.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,876.18
|
| Rate for Payer: Healthscope Commercial |
$2,251.42
|
| Rate for Payer: Healthscope Whirlpool |
$2,251.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,969.99
|
| Rate for Payer: Meridian Medicaid |
$1,252.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,063.80
|
| Rate for Payer: Nomi Health Commercial |
$2,251.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,319.25
|
| Rate for Payer: PACE SWMI |
$1,876.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,876.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,193.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,185.78
|
| Rate for Payer: Priority Health Medicare |
$1,876.18
|
| Rate for Payer: Priority Health Narrow Network |
$3,185.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,876.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,589.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,876.18
|
| Rate for Payer: UHC Exchange |
$3,589.52
|
| Rate for Payer: UHC Medicaid |
$1,193.01
|
| Rate for Payer: UHCCP DNSP |
$1,876.18
|
| Rate for Payer: UHCCP Medicaid |
$1,193.01
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK
|
Professional
|
Both
|
$1,558.00
|
|
|
Service Code
|
HCPCS 35800
|
| Min. Negotiated Rate |
$421.74 |
| Max. Negotiated Rate |
$1,272.83 |
| Rate for Payer: Aetna Commercial |
$877.27
|
| Rate for Payer: Aetna Medicare |
$654.68
|
| Rate for Payer: BCBS Complete |
$442.83
|
| Rate for Payer: BCBS MAPPO |
$654.68
|
| Rate for Payer: BCN Commercial |
$1,097.05
|
| Rate for Payer: BCN Medicare Advantage |
$654.68
|
| Rate for Payer: Cash Price |
$1,246.40
|
| Rate for Payer: Cash Price |
$1,246.40
|
| Rate for Payer: Cofinity Commercial |
$942.74
|
| Rate for Payer: Cofinity Commercial |
$877.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$654.68
|
| Rate for Payer: Healthscope Commercial |
$785.62
|
| Rate for Payer: Healthscope Whirlpool |
$785.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$687.41
|
| Rate for Payer: Meridian Medicaid |
$442.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$720.15
|
| Rate for Payer: Nomi Health Commercial |
$785.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,168.50
|
| Rate for Payer: PACE SWMI |
$654.68
|
| Rate for Payer: PHP Medicare Advantage |
$654.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$421.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,179.74
|
| Rate for Payer: Priority Health Medicare |
$654.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,179.74
|
| Rate for Payer: Railroad Medicare Medicare |
$654.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,272.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$654.68
|
| Rate for Payer: UHC Exchange |
$1,272.83
|
| Rate for Payer: UHC Medicaid |
$421.74
|
| Rate for Payer: UHCCP DNSP |
$654.68
|
| Rate for Payer: UHCCP Medicaid |
$421.74
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR
|
Professional
|
Both
|
$1,570.00
|
|
|
Service Code
|
HCPCS 35860
|
| Min. Negotiated Rate |
$494.59 |
| Max. Negotiated Rate |
$1,497.15 |
| Rate for Payer: Aetna Commercial |
$1,042.43
|
| Rate for Payer: Aetna Medicare |
$777.93
|
| Rate for Payer: BCBS Complete |
$519.32
|
| Rate for Payer: BCBS MAPPO |
$777.93
|
| Rate for Payer: BCN Commercial |
$1,242.47
|
| Rate for Payer: BCN Medicare Advantage |
$777.93
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cofinity Commercial |
$1,120.22
|
| Rate for Payer: Cofinity Commercial |
$1,042.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.93
|
| Rate for Payer: Healthscope Commercial |
$933.52
|
| Rate for Payer: Healthscope Whirlpool |
$933.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$816.83
|
| Rate for Payer: Meridian Medicaid |
$519.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$855.72
|
| Rate for Payer: Nomi Health Commercial |
$933.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,177.50
|
| Rate for Payer: PACE SWMI |
$777.93
|
| Rate for Payer: PHP Medicare Advantage |
$777.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,336.12
|
| Rate for Payer: Priority Health Medicare |
$777.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,336.12
|
| Rate for Payer: Railroad Medicare Medicare |
$777.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,497.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$777.93
|
| Rate for Payer: UHC Exchange |
$1,497.15
|
| Rate for Payer: UHC Medicaid |
$494.59
|
| Rate for Payer: UHCCP DNSP |
$777.93
|
| Rate for Payer: UHCCP Medicaid |
$494.59
|
|
|
PR EXPL RETROPERITONEUM W/WO BX SPX
|
Professional
|
Both
|
$2,093.00
|
|
|
Service Code
|
HCPCS 49010
|
| Min. Negotiated Rate |
$551.24 |
| Max. Negotiated Rate |
$1,690.42 |
| Rate for Payer: Aetna Commercial |
$1,156.03
|
| Rate for Payer: Aetna Medicare |
$862.71
|
| Rate for Payer: BCBS Complete |
$578.80
|
| Rate for Payer: BCBS MAPPO |
$862.71
|
| Rate for Payer: BCN Commercial |
$1,387.37
|
| Rate for Payer: BCN Medicare Advantage |
$862.71
|
| Rate for Payer: Cash Price |
$1,674.40
|
| Rate for Payer: Cash Price |
$1,674.40
|
| Rate for Payer: Cofinity Commercial |
$1,242.30
|
| Rate for Payer: Cofinity Commercial |
$1,156.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.71
|
| Rate for Payer: Healthscope Commercial |
$1,035.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,035.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.85
|
| Rate for Payer: Meridian Medicaid |
$578.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$948.98
|
| Rate for Payer: Nomi Health Commercial |
$1,035.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,569.75
|
| Rate for Payer: PACE SWMI |
$862.71
|
| Rate for Payer: PHP Medicare Advantage |
$862.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,690.42
|
| Rate for Payer: Priority Health Medicare |
$862.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,690.42
|
| Rate for Payer: Railroad Medicare Medicare |
$862.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,649.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$862.71
|
| Rate for Payer: UHC Exchange |
$1,649.03
|
| Rate for Payer: UHC Medicaid |
$551.24
|
| Rate for Payer: UHCCP DNSP |
$862.71
|
| Rate for Payer: UHCCP Medicaid |
$551.24
|
|
|
PR EXPL RPR & PRESACRAL DRG RECTAL INJURY
|
Professional
|
Both
|
$3,170.00
|
|
|
Service Code
|
HCPCS 45562
|
| Min. Negotiated Rate |
$716.32 |
| Max. Negotiated Rate |
$2,377.50 |
| Rate for Payer: Aetna Commercial |
$1,487.83
|
| Rate for Payer: Aetna Medicare |
$1,110.32
|
| Rate for Payer: BCBS Complete |
$752.14
|
| Rate for Payer: BCBS MAPPO |
$1,110.32
|
| Rate for Payer: BCN Commercial |
$1,761.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,110.32
|
| Rate for Payer: Cash Price |
$2,536.00
|
| Rate for Payer: Cash Price |
$2,536.00
|
| Rate for Payer: Cofinity Commercial |
$1,598.86
|
| Rate for Payer: Cofinity Commercial |
$1,487.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,110.32
|
| Rate for Payer: Healthscope Commercial |
$1,332.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,332.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,165.84
|
| Rate for Payer: Meridian Medicaid |
$752.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,221.35
|
| Rate for Payer: Nomi Health Commercial |
$1,332.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,377.50
|
| Rate for Payer: PACE SWMI |
$1,110.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,110.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,146.71
|
| Rate for Payer: Priority Health Medicare |
$1,110.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,146.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,110.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,995.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,110.32
|
| Rate for Payer: UHC Exchange |
$1,995.41
|
| Rate for Payer: UHC Medicaid |
$716.32
|
| Rate for Payer: UHCCP DNSP |
$1,110.32
|
| Rate for Payer: UHCCP Medicaid |
$716.32
|
|
|
PR EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL
|
Professional
|
Both
|
$1,338.00
|
|
|
Service Code
|
HCPCS 54560
|
| Min. Negotiated Rate |
$397.46 |
| Max. Negotiated Rate |
$1,211.84 |
| Rate for Payer: Aetna Commercial |
$822.96
|
| Rate for Payer: Aetna Medicare |
$614.15
|
| Rate for Payer: BCBS Complete |
$417.33
|
| Rate for Payer: BCBS MAPPO |
$614.15
|
| Rate for Payer: BCN Commercial |
$1,030.82
|
| Rate for Payer: BCN Medicare Advantage |
$614.15
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cofinity Commercial |
$884.38
|
| Rate for Payer: Cofinity Commercial |
$822.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.15
|
| Rate for Payer: Healthscope Commercial |
$736.98
|
| Rate for Payer: Healthscope Whirlpool |
$736.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$644.86
|
| Rate for Payer: Meridian Medicaid |
$417.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$675.57
|
| Rate for Payer: Nomi Health Commercial |
$736.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,003.50
|
| Rate for Payer: PACE SWMI |
$614.15
|
| Rate for Payer: PHP Medicare Advantage |
$614.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,122.89
|
| Rate for Payer: Priority Health Medicare |
$614.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,122.89
|
| Rate for Payer: Railroad Medicare Medicare |
$614.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$614.15
|
| Rate for Payer: UHC Exchange |
$1,211.84
|
| Rate for Payer: UHC Medicaid |
$397.46
|
| Rate for Payer: UHCCP DNSP |
$614.15
|
| Rate for Payer: UHCCP Medicaid |
$397.46
|
|
|
PR EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 54550
|
| Min. Negotiated Rate |
$287.98 |
| Max. Negotiated Rate |
$865.86 |
| Rate for Payer: Aetna Commercial |
$594.75
|
| Rate for Payer: Aetna Medicare |
$443.84
|
| Rate for Payer: BCBS Complete |
$302.38
|
| Rate for Payer: BCBS MAPPO |
$443.84
|
| Rate for Payer: BCN Commercial |
$740.00
|
| Rate for Payer: BCN Medicare Advantage |
$443.84
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cofinity Commercial |
$639.13
|
| Rate for Payer: Cofinity Commercial |
$594.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.84
|
| Rate for Payer: Healthscope Commercial |
$532.61
|
| Rate for Payer: Healthscope Whirlpool |
$532.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$466.03
|
| Rate for Payer: Meridian Medicaid |
$302.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$488.22
|
| Rate for Payer: Nomi Health Commercial |
$532.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$717.00
|
| Rate for Payer: PACE SWMI |
$443.84
|
| Rate for Payer: PHP Medicare Advantage |
$443.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$806.10
|
| Rate for Payer: Priority Health Medicare |
$443.84
|
| Rate for Payer: Priority Health Narrow Network |
$806.10
|
| Rate for Payer: Railroad Medicare Medicare |
$443.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$865.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$443.84
|
| Rate for Payer: UHC Exchange |
$865.86
|
| Rate for Payer: UHC Medicaid |
$287.98
|
| Rate for Payer: UHCCP DNSP |
$443.84
|
| Rate for Payer: UHCCP Medicaid |
$287.98
|
|
|
PR EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 25248
|
| Min. Negotiated Rate |
$260.29 |
| Max. Negotiated Rate |
$721.67 |
| Rate for Payer: Aetna Commercial |
$530.35
|
| Rate for Payer: Aetna Medicare |
$395.78
|
| Rate for Payer: BCBS Complete |
$273.30
|
| Rate for Payer: BCBS MAPPO |
$395.78
|
| Rate for Payer: BCN Commercial |
$642.39
|
| Rate for Payer: BCN Medicare Advantage |
$395.78
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cofinity Commercial |
$569.92
|
| Rate for Payer: Cofinity Commercial |
$530.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.78
|
| Rate for Payer: Healthscope Commercial |
$474.94
|
| Rate for Payer: Healthscope Whirlpool |
$474.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.57
|
| Rate for Payer: Meridian Medicaid |
$273.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$435.36
|
| Rate for Payer: Nomi Health Commercial |
$474.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$633.75
|
| Rate for Payer: PACE SWMI |
$395.78
|
| Rate for Payer: PHP Medicare Advantage |
$395.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$686.70
|
| Rate for Payer: Priority Health Medicare |
$395.78
|
| Rate for Payer: Priority Health Narrow Network |
$686.70
|
| Rate for Payer: Railroad Medicare Medicare |
$395.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$395.78
|
| Rate for Payer: UHC Exchange |
$721.67
|
| Rate for Payer: UHC Medicaid |
$260.29
|
| Rate for Payer: UHCCP DNSP |
$395.78
|
| Rate for Payer: UHCCP Medicaid |
$260.29
|
|
