|
PR FASCIOTOMY ILIOTIBIAL OPEN
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 27305
|
| Min. Negotiated Rate |
$296.07 |
| Max. Negotiated Rate |
$1,022.25 |
| Rate for Payer: Aetna Commercial |
$603.56
|
| Rate for Payer: Aetna Medicare |
$450.42
|
| Rate for Payer: BCBS Complete |
$310.87
|
| Rate for Payer: BCBS MAPPO |
$450.42
|
| Rate for Payer: BCN Commercial |
$743.48
|
| Rate for Payer: BCN Medicare Advantage |
$450.42
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$648.60
|
| Rate for Payer: Cofinity Commercial |
$603.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.42
|
| Rate for Payer: Healthscope Commercial |
$540.50
|
| Rate for Payer: Healthscope Whirlpool |
$540.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.94
|
| Rate for Payer: Meridian Medicaid |
$310.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$495.46
|
| Rate for Payer: Nomi Health Commercial |
$540.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,022.25
|
| Rate for Payer: PACE SWMI |
$450.42
|
| Rate for Payer: PHP Medicare Advantage |
$450.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$794.76
|
| Rate for Payer: Priority Health Medicare |
$450.42
|
| Rate for Payer: Priority Health Narrow Network |
$794.76
|
| Rate for Payer: Railroad Medicare Medicare |
$450.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$836.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$450.42
|
| Rate for Payer: UHC Exchange |
$836.31
|
| Rate for Payer: UHC Medicaid |
$296.07
|
| Rate for Payer: UHCCP DNSP |
$450.42
|
| Rate for Payer: UHCCP Medicaid |
$296.07
|
|
|
PR FASCIOTOMY PALMAR OPEN PARTIAL
|
Professional
|
Both
|
$1,409.00
|
|
|
Service Code
|
HCPCS 26045
|
| Min. Negotiated Rate |
$289.04 |
| Max. Negotiated Rate |
$1,056.75 |
| Rate for Payer: Aetna Commercial |
$587.01
|
| Rate for Payer: Aetna Medicare |
$438.07
|
| Rate for Payer: BCBS Complete |
$303.49
|
| Rate for Payer: BCBS MAPPO |
$438.07
|
| Rate for Payer: BCN Commercial |
$730.53
|
| Rate for Payer: BCN Medicare Advantage |
$438.07
|
| Rate for Payer: Cash Price |
$1,127.20
|
| Rate for Payer: Cash Price |
$1,127.20
|
| Rate for Payer: Cofinity Commercial |
$630.82
|
| Rate for Payer: Cofinity Commercial |
$587.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.07
|
| Rate for Payer: Healthscope Commercial |
$525.68
|
| Rate for Payer: Healthscope Whirlpool |
$525.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$459.97
|
| Rate for Payer: Meridian Medicaid |
$303.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$481.88
|
| Rate for Payer: Nomi Health Commercial |
$525.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,056.75
|
| Rate for Payer: PACE SWMI |
$438.07
|
| Rate for Payer: PHP Medicare Advantage |
$438.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$780.92
|
| Rate for Payer: Priority Health Medicare |
$438.07
|
| Rate for Payer: Priority Health Narrow Network |
$780.92
|
| Rate for Payer: Railroad Medicare Medicare |
$438.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$812.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$438.07
|
| Rate for Payer: UHC Exchange |
$812.96
|
| Rate for Payer: UHC Medicaid |
$289.04
|
| Rate for Payer: UHCCP DNSP |
$438.07
|
| Rate for Payer: UHCCP Medicaid |
$289.04
|
|
|
PR FASCIOTOMY PALMAR PERCUTANEOUS
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
HCPCS 26040
|
| Min. Negotiated Rate |
$196.81 |
| Max. Negotiated Rate |
$718.50 |
| Rate for Payer: Aetna Commercial |
$396.69
|
| Rate for Payer: Aetna Medicare |
$296.04
|
| Rate for Payer: BCBS Complete |
$206.65
|
| Rate for Payer: BCBS MAPPO |
$296.04
|
| Rate for Payer: BCN Commercial |
$491.51
|
| Rate for Payer: BCN Medicare Advantage |
$296.04
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Cofinity Commercial |
$426.30
|
| Rate for Payer: Cofinity Commercial |
$396.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.04
|
| Rate for Payer: Healthscope Commercial |
$355.25
|
| Rate for Payer: Healthscope Whirlpool |
$355.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.84
|
| Rate for Payer: Meridian Medicaid |
$206.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$325.64
|
| Rate for Payer: Nomi Health Commercial |
$355.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.50
|
| Rate for Payer: PACE SWMI |
$296.04
|
| Rate for Payer: PHP Medicare Advantage |
$296.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$525.41
|
| Rate for Payer: Priority Health Medicare |
$296.04
|
| Rate for Payer: Priority Health Narrow Network |
$525.41
|
| Rate for Payer: Railroad Medicare Medicare |
$296.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$296.04
|
| Rate for Payer: UHC Exchange |
$538.76
|
| Rate for Payer: UHC Medicaid |
$196.81
|
| Rate for Payer: UHCCP DNSP |
$296.04
|
| Rate for Payer: UHCCP Medicaid |
$196.81
|
|
|
PR FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT
|
Professional
|
Both
|
$2,432.00
|
|
|
Service Code
|
HCPCS 26121
|
| Min. Negotiated Rate |
$358.27 |
| Max. Negotiated Rate |
$1,824.00 |
| Rate for Payer: Aetna Commercial |
$730.61
|
| Rate for Payer: Aetna Medicare |
$545.23
|
| Rate for Payer: BCBS Complete |
$376.18
|
| Rate for Payer: BCBS MAPPO |
$545.23
|
| Rate for Payer: BCN Commercial |
$922.27
|
| Rate for Payer: BCN Medicare Advantage |
$545.23
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cofinity Commercial |
$785.13
|
| Rate for Payer: Cofinity Commercial |
$730.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$545.23
|
| Rate for Payer: Healthscope Commercial |
$654.28
|
| Rate for Payer: Healthscope Whirlpool |
$654.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$572.49
|
| Rate for Payer: Meridian Medicaid |
$376.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$599.75
|
| Rate for Payer: Nomi Health Commercial |
$654.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,824.00
|
| Rate for Payer: PACE SWMI |
$545.23
|
| Rate for Payer: PHP Medicare Advantage |
$545.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$985.88
|
| Rate for Payer: Priority Health Medicare |
$545.23
|
| Rate for Payer: Priority Health Narrow Network |
$985.88
|
| Rate for Payer: Railroad Medicare Medicare |
$545.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,038.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$545.23
|
| Rate for Payer: UHC Exchange |
$1,038.61
|
| Rate for Payer: UHC Medicaid |
$358.27
|
| Rate for Payer: UHCCP DNSP |
$545.23
|
| Rate for Payer: UHCCP Medicaid |
$358.27
|
|
|
PR FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$3,041.00
|
|
|
Service Code
|
HCPCS 26123
|
| Min. Negotiated Rate |
$498.21 |
| Max. Negotiated Rate |
$2,280.75 |
| Rate for Payer: Aetna Commercial |
$1,016.63
|
| Rate for Payer: Aetna Medicare |
$758.68
|
| Rate for Payer: BCBS Complete |
$523.12
|
| Rate for Payer: BCBS MAPPO |
$758.68
|
| Rate for Payer: BCN Commercial |
$1,285.29
|
| Rate for Payer: BCN Medicare Advantage |
$758.68
|
| Rate for Payer: Cash Price |
$2,432.80
|
| Rate for Payer: Cash Price |
$2,432.80
|
| Rate for Payer: Cofinity Commercial |
$1,092.50
|
| Rate for Payer: Cofinity Commercial |
$1,016.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$758.68
|
| Rate for Payer: Healthscope Commercial |
$910.42
|
| Rate for Payer: Healthscope Whirlpool |
$910.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$796.61
|
| Rate for Payer: Meridian Medicaid |
$523.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$834.55
|
| Rate for Payer: Nomi Health Commercial |
$910.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,280.75
|
| Rate for Payer: PACE SWMI |
$758.68
|
| Rate for Payer: PHP Medicare Advantage |
$758.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,373.93
|
| Rate for Payer: Priority Health Medicare |
$758.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,373.93
|
| Rate for Payer: Railroad Medicare Medicare |
$758.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,449.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$758.68
|
| Rate for Payer: UHC Exchange |
$1,449.66
|
| Rate for Payer: UHC Medicaid |
$498.21
|
| Rate for Payer: UHCCP DNSP |
$758.68
|
| Rate for Payer: UHCCP Medicaid |
$498.21
|
|
|
PR FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 26125
|
| Min. Negotiated Rate |
$145.48 |
| Max. Negotiated Rate |
$684.00 |
| Rate for Payer: Aetna Commercial |
$304.89
|
| Rate for Payer: Aetna Medicare |
$227.53
|
| Rate for Payer: BCBS Complete |
$152.75
|
| Rate for Payer: BCBS MAPPO |
$227.53
|
| Rate for Payer: BCN Commercial |
$401.38
|
| Rate for Payer: BCN Medicare Advantage |
$227.53
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$327.64
|
| Rate for Payer: Cofinity Commercial |
$304.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.53
|
| Rate for Payer: Healthscope Commercial |
$273.04
|
| Rate for Payer: Healthscope Whirlpool |
$273.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.91
|
| Rate for Payer: Meridian Medicaid |
$152.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$250.28
|
| Rate for Payer: Nomi Health Commercial |
$273.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.00
|
| Rate for Payer: PACE SWMI |
$227.53
|
| Rate for Payer: PHP Medicare Advantage |
$227.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$429.05
|
| Rate for Payer: Priority Health Medicare |
$227.53
|
| Rate for Payer: Priority Health Narrow Network |
$429.05
|
| Rate for Payer: Railroad Medicare Medicare |
$227.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$481.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$227.53
|
| Rate for Payer: UHC Exchange |
$481.08
|
| Rate for Payer: UHC Medicaid |
$145.48
|
| Rate for Payer: UHCCP DNSP |
$227.53
|
| Rate for Payer: UHCCP Medicaid |
$145.48
|
|
|
PR FECAL BLOOD SCRN IMMUNOASSAY
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS G0328
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Commercial |
$24.19
|
| Rate for Payer: Aetna Medicare |
$18.05
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCN Commercial |
$18.05
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$24.19
|
| Rate for Payer: Cofinity Commercial |
$25.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$21.66
|
| Rate for Payer: Healthscope Whirlpool |
$21.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.86
|
| Rate for Payer: Nomi Health Commercial |
$21.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18.82
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health Narrow Network |
$18.82
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.05
|
| Rate for Payer: UHC Exchange |
$7.58
|
| Rate for Payer: UHCCP DNSP |
$18.05
|
|
|
PR FECAL MICROBIOTA PREP INSTIL
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS G0455
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$81.65
|
| Rate for Payer: Aetna Medicare |
$60.93
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$60.93
|
| Rate for Payer: BCN Commercial |
$104.58
|
| Rate for Payer: BCN Medicare Advantage |
$60.93
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$87.74
|
| Rate for Payer: Cofinity Commercial |
$81.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.93
|
| Rate for Payer: Healthscope Commercial |
$73.12
|
| Rate for Payer: Healthscope Whirlpool |
$73.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.98
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.02
|
| Rate for Payer: Nomi Health Commercial |
$73.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$60.93
|
| Rate for Payer: PHP Medicare Advantage |
$60.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$127.42
|
| Rate for Payer: Priority Health Medicare |
$60.93
|
| Rate for Payer: Priority Health Narrow Network |
$127.42
|
| Rate for Payer: Railroad Medicare Medicare |
$60.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.93
|
| Rate for Payer: UHC Exchange |
$117.30
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP DNSP |
$60.93
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
|
PR FERN TEST
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS Q0114
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$14.03 |
| Rate for Payer: Aetna Commercial |
$13.05
|
| Rate for Payer: Aetna Medicare |
$9.74
|
| Rate for Payer: BCBS MAPPO |
$9.74
|
| Rate for Payer: BCN Commercial |
$6.83
|
| Rate for Payer: BCN Medicare Advantage |
$9.74
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$14.03
|
| Rate for Payer: Cofinity Commercial |
$13.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.74
|
| Rate for Payer: Healthscope Commercial |
$11.69
|
| Rate for Payer: Healthscope Whirlpool |
$11.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.71
|
| Rate for Payer: Nomi Health Commercial |
$11.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.50
|
| Rate for Payer: PACE SWMI |
$9.74
|
| Rate for Payer: PHP Medicare Advantage |
$9.74
|
| Rate for Payer: Priority Health Medicare |
$9.74
|
| Rate for Payer: Railroad Medicare Medicare |
$9.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.74
|
| Rate for Payer: UHC Exchange |
$5.84
|
| Rate for Payer: UHCCP DNSP |
$9.74
|
|
|
PR FETAL CONTRACTION STRESS TEST
|
Professional
|
Both
|
$169.00
|
|
|
Service Code
|
HCPCS 59020
|
| Min. Negotiated Rate |
$69.71 |
| Max. Negotiated Rate |
$126.75 |
| Rate for Payer: Aetna Commercial |
$93.41
|
| Rate for Payer: Aetna Medicare |
$69.71
|
| Rate for Payer: BCBS MAPPO |
$69.71
|
| Rate for Payer: BCN Commercial |
$106.07
|
| Rate for Payer: BCN Medicare Advantage |
$69.71
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cofinity Commercial |
$93.41
|
| Rate for Payer: Cofinity Commercial |
$100.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.71
|
| Rate for Payer: Healthscope Commercial |
$83.65
|
| Rate for Payer: Healthscope Whirlpool |
$83.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.68
|
| Rate for Payer: Nomi Health Commercial |
$83.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.75
|
| Rate for Payer: PACE SWMI |
$69.71
|
| Rate for Payer: PHP Medicare Advantage |
$69.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$100.13
|
| Rate for Payer: Priority Health Medicare |
$69.71
|
| Rate for Payer: Priority Health Narrow Network |
$100.13
|
| Rate for Payer: Railroad Medicare Medicare |
$69.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.71
|
| Rate for Payer: UHC Exchange |
$119.33
|
| Rate for Payer: UHCCP DNSP |
$69.71
|
|
|
PR FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 59074
|
| Min. Negotiated Rate |
$175.73 |
| Max. Negotiated Rate |
$650.25 |
| Rate for Payer: Aetna Commercial |
$372.77
|
| Rate for Payer: Aetna Medicare |
$278.19
|
| Rate for Payer: BCBS Complete |
$184.52
|
| Rate for Payer: BCBS MAPPO |
$278.19
|
| Rate for Payer: BCN Commercial |
$461.63
|
| Rate for Payer: BCN Medicare Advantage |
$278.19
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$400.59
|
| Rate for Payer: Cofinity Commercial |
$372.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.19
|
| Rate for Payer: Healthscope Commercial |
$333.83
|
| Rate for Payer: Healthscope Whirlpool |
$333.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.10
|
| Rate for Payer: Meridian Medicaid |
$184.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.01
|
| Rate for Payer: Nomi Health Commercial |
$333.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$650.25
|
| Rate for Payer: PACE SWMI |
$278.19
|
| Rate for Payer: PHP Medicare Advantage |
$278.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$435.78
|
| Rate for Payer: Priority Health Medicare |
$278.19
|
| Rate for Payer: Priority Health Narrow Network |
$435.78
|
| Rate for Payer: Railroad Medicare Medicare |
$278.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.19
|
| Rate for Payer: UHC Exchange |
$552.12
|
| Rate for Payer: UHC Medicaid |
$175.73
|
| Rate for Payer: UHCCP DNSP |
$278.19
|
| Rate for Payer: UHCCP Medicaid |
$175.73
|
|
|
PR FETAL NONSTRESS TEST
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 59025
|
| Min. Negotiated Rate |
$48.57 |
| Max. Negotiated Rate |
$82.18 |
| Rate for Payer: Aetna Commercial |
$65.08
|
| Rate for Payer: Aetna Medicare |
$48.57
|
| Rate for Payer: BCBS MAPPO |
$48.57
|
| Rate for Payer: BCN Commercial |
$73.70
|
| Rate for Payer: BCN Medicare Advantage |
$48.57
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$65.08
|
| Rate for Payer: Cofinity Commercial |
$69.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.57
|
| Rate for Payer: Healthscope Commercial |
$58.28
|
| Rate for Payer: Healthscope Whirlpool |
$58.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.43
|
| Rate for Payer: Nomi Health Commercial |
$58.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: PACE SWMI |
$48.57
|
| Rate for Payer: PHP Medicare Advantage |
$48.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.57
|
| Rate for Payer: Priority Health Medicare |
$48.57
|
| Rate for Payer: Priority Health Narrow Network |
$69.57
|
| Rate for Payer: Railroad Medicare Medicare |
$48.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.57
|
| Rate for Payer: UHC Exchange |
$82.18
|
| Rate for Payer: UHCCP DNSP |
$48.57
|
|
|
PR FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 59076
|
| Min. Negotiated Rate |
$295.22 |
| Max. Negotiated Rate |
$934.43 |
| Rate for Payer: Aetna Commercial |
$627.68
|
| Rate for Payer: Aetna Medicare |
$468.42
|
| Rate for Payer: BCBS Complete |
$309.98
|
| Rate for Payer: BCBS MAPPO |
$468.42
|
| Rate for Payer: BCN Commercial |
$777.85
|
| Rate for Payer: BCN Medicare Advantage |
$468.42
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$674.52
|
| Rate for Payer: Cofinity Commercial |
$627.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.42
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Healthscope Whirlpool |
$562.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.84
|
| Rate for Payer: Meridian Medicaid |
$309.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$515.26
|
| Rate for Payer: Nomi Health Commercial |
$562.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$823.50
|
| Rate for Payer: PACE SWMI |
$468.42
|
| Rate for Payer: PHP Medicare Advantage |
$468.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$734.29
|
| Rate for Payer: Priority Health Medicare |
$468.42
|
| Rate for Payer: Priority Health Narrow Network |
$734.29
|
| Rate for Payer: Railroad Medicare Medicare |
$468.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$934.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$468.42
|
| Rate for Payer: UHC Exchange |
$934.43
|
| Rate for Payer: UHC Medicaid |
$295.22
|
| Rate for Payer: UHCCP DNSP |
$468.42
|
| Rate for Payer: UHCCP Medicaid |
$295.22
|
|
|
PR FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE
|
Professional
|
Both
|
$1,332.00
|
|
|
Service Code
|
HCPCS 14350
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$1,198.81 |
| Rate for Payer: Aetna Commercial |
$804.96
|
| Rate for Payer: Aetna Medicare |
$600.72
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS MAPPO |
$600.72
|
| Rate for Payer: BCN Commercial |
$1,001.94
|
| Rate for Payer: BCN Medicare Advantage |
$600.72
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cofinity Commercial |
$865.04
|
| Rate for Payer: Cofinity Commercial |
$804.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.72
|
| Rate for Payer: Healthscope Commercial |
$720.86
|
| Rate for Payer: Healthscope Whirlpool |
$720.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.76
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$660.79
|
| Rate for Payer: Nomi Health Commercial |
$720.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$999.00
|
| Rate for Payer: PACE SWMI |
$600.72
|
| Rate for Payer: PHP Medicare Advantage |
$600.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$917.03
|
| Rate for Payer: Priority Health Medicare |
$600.72
|
| Rate for Payer: Priority Health Narrow Network |
$917.03
|
| Rate for Payer: Railroad Medicare Medicare |
$600.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,198.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$600.72
|
| Rate for Payer: UHC Exchange |
$1,198.81
|
| Rate for Payer: UHC Medicaid |
$392.13
|
| Rate for Payer: UHCCP DNSP |
$600.72
|
| Rate for Payer: UHCCP Medicaid |
$392.13
|
|
|
PR FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 10009
|
| Min. Negotiated Rate |
$59.43 |
| Max. Negotiated Rate |
$204.75 |
| Rate for Payer: Aetna Commercial |
$124.79
|
| Rate for Payer: Aetna Commercial |
$124.79
|
| Rate for Payer: Aetna Medicare |
$93.13
|
| Rate for Payer: Aetna Medicare |
$93.13
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS MAPPO |
$93.13
|
| Rate for Payer: BCBS MAPPO |
$93.13
|
| Rate for Payer: BCN Commercial |
$126.06
|
| Rate for Payer: BCN Commercial |
$126.06
|
| Rate for Payer: BCN Medicare Advantage |
$93.13
|
| Rate for Payer: BCN Medicare Advantage |
$93.13
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cofinity Commercial |
$124.79
|
| Rate for Payer: Cofinity Commercial |
$134.11
|
| Rate for Payer: Cofinity Commercial |
$124.79
|
| Rate for Payer: Cofinity Commercial |
$134.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.13
|
| Rate for Payer: Healthscope Commercial |
$111.76
|
| Rate for Payer: Healthscope Commercial |
$111.76
|
| Rate for Payer: Healthscope Whirlpool |
$111.76
|
| Rate for Payer: Healthscope Whirlpool |
$111.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.79
|
| Rate for Payer: Meridian Medicaid |
$62.40
|
| Rate for Payer: Meridian Medicaid |
$62.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.44
|
| Rate for Payer: Nomi Health Commercial |
$111.76
|
| Rate for Payer: Nomi Health Commercial |
$111.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$568.50
|
| Rate for Payer: PACE SWMI |
$93.13
|
| Rate for Payer: PACE SWMI |
$93.13
|
| Rate for Payer: PHP Medicare Advantage |
$93.13
|
| Rate for Payer: PHP Medicare Advantage |
$93.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$146.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$146.30
|
| Rate for Payer: Priority Health Medicare |
$93.13
|
| Rate for Payer: Priority Health Medicare |
$93.13
|
| Rate for Payer: Priority Health Narrow Network |
$146.30
|
| Rate for Payer: Priority Health Narrow Network |
$146.30
|
| Rate for Payer: Railroad Medicare Medicare |
$93.13
|
| Rate for Payer: Railroad Medicare Medicare |
$93.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.13
|
| Rate for Payer: UHC Exchange |
$201.68
|
| Rate for Payer: UHC Exchange |
$201.68
|
| Rate for Payer: UHC Medicaid |
$59.43
|
| Rate for Payer: UHC Medicaid |
$59.43
|
| Rate for Payer: UHCCP DNSP |
$93.13
|
| Rate for Payer: UHCCP DNSP |
$93.13
|
| Rate for Payer: UHCCP Medicaid |
$59.43
|
| Rate for Payer: UHCCP Medicaid |
$59.43
|
|
|
PR FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 10021
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$183.75 |
| Rate for Payer: Aetna Commercial |
$61.64
|
| Rate for Payer: Aetna Medicare |
$46.00
|
| Rate for Payer: BCBS Complete |
$30.86
|
| Rate for Payer: BCBS MAPPO |
$46.00
|
| Rate for Payer: BCN Commercial |
$64.80
|
| Rate for Payer: BCN Medicare Advantage |
$46.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$66.24
|
| Rate for Payer: Cofinity Commercial |
$61.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.00
|
| Rate for Payer: Healthscope Commercial |
$55.20
|
| Rate for Payer: Healthscope Whirlpool |
$55.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.30
|
| Rate for Payer: Meridian Medicaid |
$30.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.60
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.75
|
| Rate for Payer: PACE SWMI |
$46.00
|
| Rate for Payer: PHP Medicare Advantage |
$46.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$75.20
|
| Rate for Payer: Priority Health Medicare |
$46.00
|
| Rate for Payer: Priority Health Narrow Network |
$75.20
|
| Rate for Payer: Railroad Medicare Medicare |
$46.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.00
|
| Rate for Payer: UHC Exchange |
$98.12
|
| Rate for Payer: UHC Medicaid |
$29.39
|
| Rate for Payer: UHCCP DNSP |
$46.00
|
| Rate for Payer: UHCCP Medicaid |
$29.39
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 10005
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$83.59
|
| Rate for Payer: Aetna Medicare |
$62.38
|
| Rate for Payer: BCBS Complete |
$41.82
|
| Rate for Payer: BCBS MAPPO |
$62.38
|
| Rate for Payer: BCN Commercial |
$85.22
|
| Rate for Payer: BCN Medicare Advantage |
$62.38
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$89.83
|
| Rate for Payer: Cofinity Commercial |
$83.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.38
|
| Rate for Payer: Healthscope Commercial |
$74.86
|
| Rate for Payer: Healthscope Whirlpool |
$74.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.50
|
| Rate for Payer: Meridian Medicaid |
$41.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.62
|
| Rate for Payer: Nomi Health Commercial |
$74.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PACE SWMI |
$62.38
|
| Rate for Payer: PHP Medicare Advantage |
$62.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$98.90
|
| Rate for Payer: Priority Health Medicare |
$62.38
|
| Rate for Payer: Priority Health Narrow Network |
$98.90
|
| Rate for Payer: Railroad Medicare Medicare |
$62.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.38
|
| Rate for Payer: UHC Exchange |
$127.42
|
| Rate for Payer: UHC Medicaid |
$39.83
|
| Rate for Payer: UHCCP DNSP |
$62.38
|
| Rate for Payer: UHCCP Medicaid |
$39.83
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 10006
|
| Min. Negotiated Rate |
$27.48 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$57.59
|
| Rate for Payer: Aetna Medicare |
$42.98
|
| Rate for Payer: BCBS Complete |
$28.85
|
| Rate for Payer: BCBS MAPPO |
$42.98
|
| Rate for Payer: BCN Commercial |
$58.12
|
| Rate for Payer: BCN Medicare Advantage |
$42.98
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$57.59
|
| Rate for Payer: Cofinity Commercial |
$61.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.98
|
| Rate for Payer: Healthscope Commercial |
$51.58
|
| Rate for Payer: Healthscope Whirlpool |
$51.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.13
|
| Rate for Payer: Meridian Medicaid |
$28.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.28
|
| Rate for Payer: Nomi Health Commercial |
$51.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: PACE SWMI |
$42.98
|
| Rate for Payer: PHP Medicare Advantage |
$42.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.45
|
| Rate for Payer: Priority Health Medicare |
$42.98
|
| Rate for Payer: Priority Health Narrow Network |
$67.45
|
| Rate for Payer: Railroad Medicare Medicare |
$42.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.98
|
| Rate for Payer: UHC Exchange |
$87.40
|
| Rate for Payer: UHC Medicaid |
$27.48
|
| Rate for Payer: UHCCP DNSP |
$42.98
|
| Rate for Payer: UHCCP Medicaid |
$27.48
|
|
|
PR FINE NEEDLE ASP;W/IMAGING GUIDANCE
|
Professional
|
Both
|
$277.00
|
|
|
Service Code
|
HCPCS 10022
|
| Min. Negotiated Rate |
$110.80 |
| Max. Negotiated Rate |
$207.75 |
| Rate for Payer: BCBS Complete |
$110.80
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.75
|
|
|
PR FINGER SPLINT, STATIC
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS Q4049
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$3.86 |
| Rate for Payer: Aetna Commercial |
$3.59
|
| Rate for Payer: Aetna Medicare |
$2.68
|
| Rate for Payer: BCBS MAPPO |
$2.68
|
| Rate for Payer: BCN Commercial |
$2.57
|
| Rate for Payer: BCN Medicare Advantage |
$2.68
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$3.59
|
| Rate for Payer: Cofinity Commercial |
$3.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.68
|
| Rate for Payer: Healthscope Commercial |
$3.22
|
| Rate for Payer: Healthscope Whirlpool |
$3.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.95
|
| Rate for Payer: Nomi Health Commercial |
$3.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
| Rate for Payer: PACE SWMI |
$2.68
|
| Rate for Payer: PHP Medicare Advantage |
$2.68
|
| Rate for Payer: Priority Health Medicare |
$2.68
|
| Rate for Payer: Railroad Medicare Medicare |
$2.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.68
|
| Rate for Payer: UHC Exchange |
$0.88
|
| Rate for Payer: UHCCP DNSP |
$2.68
|
|
|
PR FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
HCPCS 46200
|
| Min. Negotiated Rate |
$221.73 |
| Max. Negotiated Rate |
$743.25 |
| Rate for Payer: Aetna Commercial |
$444.81
|
| Rate for Payer: Aetna Medicare |
$331.95
|
| Rate for Payer: BCBS Complete |
$232.82
|
| Rate for Payer: BCBS MAPPO |
$331.95
|
| Rate for Payer: BCN Commercial |
$515.90
|
| Rate for Payer: BCN Medicare Advantage |
$331.95
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cofinity Commercial |
$478.01
|
| Rate for Payer: Cofinity Commercial |
$444.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.95
|
| Rate for Payer: Healthscope Commercial |
$398.34
|
| Rate for Payer: Healthscope Whirlpool |
$398.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.55
|
| Rate for Payer: Meridian Medicaid |
$232.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.14
|
| Rate for Payer: Nomi Health Commercial |
$398.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$743.25
|
| Rate for Payer: PACE SWMI |
$331.95
|
| Rate for Payer: PHP Medicare Advantage |
$331.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$628.60
|
| Rate for Payer: Priority Health Medicare |
$331.95
|
| Rate for Payer: Priority Health Narrow Network |
$628.60
|
| Rate for Payer: Railroad Medicare Medicare |
$331.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$570.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$331.95
|
| Rate for Payer: UHC Exchange |
$570.58
|
| Rate for Payer: UHC Medicaid |
$221.73
|
| Rate for Payer: UHCCP DNSP |
$331.95
|
| Rate for Payer: UHCCP Medicaid |
$221.73
|
|
|
PR FIT CONTACT LENS TX OCULAR SURFACE DISEASE
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 92071
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Aetna Commercial |
$34.36
|
| Rate for Payer: Aetna Medicare |
$25.64
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$25.64
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: BCN Medicare Advantage |
$25.64
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$36.92
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.64
|
| Rate for Payer: Healthscope Commercial |
$30.77
|
| Rate for Payer: Healthscope Whirlpool |
$30.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.92
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.20
|
| Rate for Payer: Nomi Health Commercial |
$30.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.75
|
| Rate for Payer: PACE SWMI |
$25.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$40.48
|
| Rate for Payer: Priority Health Medicare |
$25.64
|
| Rate for Payer: Priority Health Narrow Network |
$40.48
|
| Rate for Payer: Railroad Medicare Medicare |
$25.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.64
|
| Rate for Payer: UHC Exchange |
$41.73
|
| Rate for Payer: UHC Medicaid |
$16.61
|
| Rate for Payer: UHCCP DNSP |
$25.64
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
|
|
PR FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 57160
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$54.28
|
| Rate for Payer: Aetna Medicare |
$40.51
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$40.51
|
| Rate for Payer: BCN Commercial |
$68.72
|
| Rate for Payer: BCN Medicare Advantage |
$40.51
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$58.33
|
| Rate for Payer: Cofinity Commercial |
$54.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.51
|
| Rate for Payer: Healthscope Commercial |
$48.61
|
| Rate for Payer: Healthscope Whirlpool |
$48.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.54
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.56
|
| Rate for Payer: Nomi Health Commercial |
$48.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
| Rate for Payer: PACE SWMI |
$40.51
|
| Rate for Payer: PHP Medicare Advantage |
$40.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.60
|
| Rate for Payer: Priority Health Medicare |
$40.51
|
| Rate for Payer: Priority Health Narrow Network |
$69.60
|
| Rate for Payer: Railroad Medicare Medicare |
$40.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.51
|
| Rate for Payer: UHC Exchange |
$83.00
|
| Rate for Payer: UHC Medicaid |
$25.77
|
| Rate for Payer: UHCCP DNSP |
$40.51
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR FITTING CONTACT LENS FOR MGMT OF KERATOCONUS 1ST
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 92072
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna Commercial |
$101.16
|
| Rate for Payer: Aetna Medicare |
$75.49
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$75.49
|
| Rate for Payer: BCN Commercial |
$136.44
|
| Rate for Payer: BCN Medicare Advantage |
$75.49
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$108.71
|
| Rate for Payer: Cofinity Commercial |
$101.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.49
|
| Rate for Payer: Healthscope Commercial |
$90.59
|
| Rate for Payer: Healthscope Whirlpool |
$90.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.26
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.04
|
| Rate for Payer: Nomi Health Commercial |
$90.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.00
|
| Rate for Payer: PACE SWMI |
$75.49
|
| Rate for Payer: PHP Medicare Advantage |
$75.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$116.75
|
| Rate for Payer: Priority Health Medicare |
$75.49
|
| Rate for Payer: Priority Health Narrow Network |
$116.75
|
| Rate for Payer: Railroad Medicare Medicare |
$75.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.49
|
| Rate for Payer: UHC Exchange |
$123.10
|
| Rate for Payer: UHC Medicaid |
$48.78
|
| Rate for Payer: UHCCP DNSP |
$75.49
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
|
|
PR FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 54620
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$527.41 |
| Rate for Payer: Aetna Commercial |
$359.51
|
| Rate for Payer: Aetna Medicare |
$268.29
|
| Rate for Payer: BCBS Complete |
$182.50
|
| Rate for Payer: BCBS MAPPO |
$268.29
|
| Rate for Payer: BCN Commercial |
$447.69
|
| Rate for Payer: BCN Medicare Advantage |
$268.29
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$386.34
|
| Rate for Payer: Cofinity Commercial |
$359.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.29
|
| Rate for Payer: Healthscope Commercial |
$321.95
|
| Rate for Payer: Healthscope Whirlpool |
$321.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.70
|
| Rate for Payer: Meridian Medicaid |
$182.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.12
|
| Rate for Payer: Nomi Health Commercial |
$321.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$443.25
|
| Rate for Payer: PACE SWMI |
$268.29
|
| Rate for Payer: PHP Medicare Advantage |
$268.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$487.68
|
| Rate for Payer: Priority Health Medicare |
$268.29
|
| Rate for Payer: Priority Health Narrow Network |
$487.68
|
| Rate for Payer: Railroad Medicare Medicare |
$268.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$527.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$268.29
|
| Rate for Payer: UHC Exchange |
$527.41
|
| Rate for Payer: UHC Medicaid |
$173.81
|
| Rate for Payer: UHCCP DNSP |
$268.29
|
| Rate for Payer: UHCCP Medicaid |
$173.81
|
|
