|
PR HIB-HEPB VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 90748
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$204.75 |
| Rate for Payer: Aetna Commercial |
$42.90
|
| Rate for Payer: BCBS Complete |
$109.20
|
| Rate for Payer: BCBS Trust/PPO |
$42.85
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.47
|
| Rate for Payer: UHC Exchange |
$50.47
|
|
|
PR HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 90647
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$31.47 |
| Rate for Payer: Aetna Commercial |
$30.53
|
| Rate for Payer: BCBS Trust/PPO |
$31.47
|
| Rate for Payer: BCN Commercial |
$29.96
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.47
|
| Rate for Payer: UHC Exchange |
$31.47
|
|
|
PR HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 90648
|
| Min. Negotiated Rate |
$13.07 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$13.17
|
| Rate for Payer: BCN Commercial |
$13.07
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.54
|
| Rate for Payer: UHC Exchange |
$13.54
|
|
|
PR HIB VACCINE, HBOC, IM
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 90645
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$24.75 |
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
|
|
PR HIB VACCINE, PRP-D, IM
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 90646
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
|
|
PR HINGE EXTENSION/FLEX WRIST/F
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS L3900
|
| Min. Negotiated Rate |
$590.79 |
| Max. Negotiated Rate |
$2,609.06 |
| Rate for Payer: Aetna Commercial |
$2,427.88
|
| Rate for Payer: Aetna Medicare |
$1,811.85
|
| Rate for Payer: BCBS Complete |
$622.80
|
| Rate for Payer: BCBS MAPPO |
$1,811.85
|
| Rate for Payer: BCN Commercial |
$1,734.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,811.85
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$2,609.06
|
| Rate for Payer: Cofinity Commercial |
$2,427.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,811.85
|
| Rate for Payer: Healthscope Commercial |
$2,174.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,174.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,902.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,993.04
|
| Rate for Payer: Nomi Health Commercial |
$2,174.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,167.75
|
| Rate for Payer: PACE SWMI |
$1,811.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,811.85
|
| Rate for Payer: Priority Health Medicare |
$1,811.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,811.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,811.85
|
| Rate for Payer: UHC Exchange |
$590.79
|
| Rate for Payer: UHCCP DNSP |
$1,811.85
|
|
|
PR HOME HEALTH CARE SUPERVISION
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS G0181
|
| Min. Negotiated Rate |
$76.00 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Commercial |
$142.33
|
| Rate for Payer: Aetna Medicare |
$106.22
|
| Rate for Payer: BCBS Complete |
$76.00
|
| Rate for Payer: BCBS MAPPO |
$106.22
|
| Rate for Payer: BCN Commercial |
$157.36
|
| Rate for Payer: BCN Medicare Advantage |
$106.22
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$152.96
|
| Rate for Payer: Cofinity Commercial |
$142.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.22
|
| Rate for Payer: Healthscope Commercial |
$127.46
|
| Rate for Payer: Healthscope Whirlpool |
$127.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.84
|
| Rate for Payer: Nomi Health Commercial |
$127.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE SWMI |
$106.22
|
| Rate for Payer: PHP Medicare Advantage |
$106.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$145.11
|
| Rate for Payer: Priority Health Medicare |
$106.22
|
| Rate for Payer: Priority Health Narrow Network |
$145.11
|
| Rate for Payer: Railroad Medicare Medicare |
$106.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$106.22
|
| Rate for Payer: UHC Exchange |
$169.65
|
| Rate for Payer: UHCCP DNSP |
$106.22
|
|
|
PR HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 99350
|
| Min. Negotiated Rate |
$188.45 |
| Max. Negotiated Rate |
$273.89 |
| Rate for Payer: Aetna Commercial |
$252.52
|
| Rate for Payer: Aetna Medicare |
$188.45
|
| Rate for Payer: BCBS MAPPO |
$188.45
|
| Rate for Payer: BCN Commercial |
$273.89
|
| Rate for Payer: BCN Medicare Advantage |
$188.45
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$252.52
|
| Rate for Payer: Cofinity Commercial |
$271.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.45
|
| Rate for Payer: Healthscope Commercial |
$207.29
|
| Rate for Payer: Healthscope Whirlpool |
$207.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$207.29
|
| Rate for Payer: Nomi Health Commercial |
$226.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: PACE SWMI |
$188.45
|
| Rate for Payer: PHP Medicare Advantage |
$188.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$246.37
|
| Rate for Payer: Priority Health Medicare |
$188.45
|
| Rate for Payer: Priority Health Narrow Network |
$246.37
|
| Rate for Payer: Railroad Medicare Medicare |
$188.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$188.45
|
| Rate for Payer: UHC Exchange |
$252.50
|
| Rate for Payer: UHCCP DNSP |
$188.45
|
|
|
PR HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 99348
|
| Min. Negotiated Rate |
$76.83 |
| Max. Negotiated Rate |
$118.31 |
| Rate for Payer: Aetna Commercial |
$102.95
|
| Rate for Payer: Aetna Medicare |
$76.83
|
| Rate for Payer: BCBS MAPPO |
$76.83
|
| Rate for Payer: BCN Commercial |
$114.04
|
| Rate for Payer: BCN Medicare Advantage |
$76.83
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$102.95
|
| Rate for Payer: Cofinity Commercial |
$110.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.83
|
| Rate for Payer: Healthscope Commercial |
$84.51
|
| Rate for Payer: Healthscope Whirlpool |
$84.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.51
|
| Rate for Payer: Nomi Health Commercial |
$92.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
| Rate for Payer: PACE SWMI |
$76.83
|
| Rate for Payer: PHP Medicare Advantage |
$76.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.57
|
| Rate for Payer: Priority Health Medicare |
$76.83
|
| Rate for Payer: Priority Health Narrow Network |
$102.57
|
| Rate for Payer: Railroad Medicare Medicare |
$76.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.83
|
| Rate for Payer: UHC Exchange |
$118.31
|
| Rate for Payer: UHCCP DNSP |
$76.83
|
|
|
PR HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 99349
|
| Min. Negotiated Rate |
$129.00 |
| Max. Negotiated Rate |
$188.74 |
| Rate for Payer: Aetna Commercial |
$172.86
|
| Rate for Payer: Aetna Medicare |
$129.00
|
| Rate for Payer: BCBS MAPPO |
$129.00
|
| Rate for Payer: BCN Commercial |
$188.74
|
| Rate for Payer: BCN Medicare Advantage |
$129.00
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$172.86
|
| Rate for Payer: Cofinity Commercial |
$185.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.00
|
| Rate for Payer: Healthscope Commercial |
$141.90
|
| Rate for Payer: Healthscope Whirlpool |
$141.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.90
|
| Rate for Payer: Nomi Health Commercial |
$154.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.25
|
| Rate for Payer: PACE SWMI |
$129.00
|
| Rate for Payer: PHP Medicare Advantage |
$129.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.76
|
| Rate for Payer: Priority Health Medicare |
$129.00
|
| Rate for Payer: Priority Health Narrow Network |
$169.76
|
| Rate for Payer: Railroad Medicare Medicare |
$129.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$129.00
|
| Rate for Payer: UHC Exchange |
$180.92
|
| Rate for Payer: UHCCP DNSP |
$129.00
|
|
|
PR HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS 99347
|
| Min. Negotiated Rate |
$44.99 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: Aetna Commercial |
$60.29
|
| Rate for Payer: Aetna Medicare |
$44.99
|
| Rate for Payer: BCBS MAPPO |
$44.99
|
| Rate for Payer: BCN Commercial |
$67.23
|
| Rate for Payer: BCN Medicare Advantage |
$44.99
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$60.29
|
| Rate for Payer: Cofinity Commercial |
$64.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.99
|
| Rate for Payer: Healthscope Commercial |
$49.49
|
| Rate for Payer: Healthscope Whirlpool |
$49.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.49
|
| Rate for Payer: Nomi Health Commercial |
$53.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.00
|
| Rate for Payer: PACE SWMI |
$44.99
|
| Rate for Payer: PHP Medicare Advantage |
$44.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$60.47
|
| Rate for Payer: Priority Health Medicare |
$44.99
|
| Rate for Payer: Priority Health Narrow Network |
$60.47
|
| Rate for Payer: Railroad Medicare Medicare |
$44.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.99
|
| Rate for Payer: UHC Exchange |
$76.78
|
| Rate for Payer: UHCCP DNSP |
$44.99
|
|
|
PR HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES
|
Professional
|
Both
|
$416.00
|
|
|
Service Code
|
HCPCS 99345
|
| Min. Negotiated Rate |
$204.89 |
| Max. Negotiated Rate |
$313.02 |
| Rate for Payer: Aetna Commercial |
$274.55
|
| Rate for Payer: Aetna Medicare |
$204.89
|
| Rate for Payer: BCBS MAPPO |
$204.89
|
| Rate for Payer: BCN Commercial |
$298.29
|
| Rate for Payer: BCN Medicare Advantage |
$204.89
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cofinity Commercial |
$274.55
|
| Rate for Payer: Cofinity Commercial |
$295.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.89
|
| Rate for Payer: Healthscope Commercial |
$225.38
|
| Rate for Payer: Healthscope Whirlpool |
$225.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$225.38
|
| Rate for Payer: Nomi Health Commercial |
$245.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.00
|
| Rate for Payer: PACE SWMI |
$204.89
|
| Rate for Payer: PHP Medicare Advantage |
$204.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$268.32
|
| Rate for Payer: Priority Health Medicare |
$204.89
|
| Rate for Payer: Priority Health Narrow Network |
$268.32
|
| Rate for Payer: Railroad Medicare Medicare |
$204.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$204.89
|
| Rate for Payer: UHC Exchange |
$313.02
|
| Rate for Payer: UHCCP DNSP |
$204.89
|
|
|
PR HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 99342
|
| Min. Negotiated Rate |
$77.27 |
| Max. Negotiated Rate |
$125.25 |
| Rate for Payer: Aetna Commercial |
$103.54
|
| Rate for Payer: Aetna Medicare |
$77.27
|
| Rate for Payer: BCBS MAPPO |
$77.27
|
| Rate for Payer: BCN Commercial |
$116.53
|
| Rate for Payer: BCN Medicare Advantage |
$77.27
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$103.54
|
| Rate for Payer: Cofinity Commercial |
$111.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.27
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Healthscope Whirlpool |
$85.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$92.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.25
|
| Rate for Payer: PACE SWMI |
$77.27
|
| Rate for Payer: PHP Medicare Advantage |
$77.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$104.81
|
| Rate for Payer: Priority Health Medicare |
$77.27
|
| Rate for Payer: Priority Health Narrow Network |
$104.81
|
| Rate for Payer: Railroad Medicare Medicare |
$77.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$77.27
|
| Rate for Payer: UHC Exchange |
$110.59
|
| Rate for Payer: UHCCP DNSP |
$77.27
|
|
|
PR HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
HCPCS 99344
|
| Min. Negotiated Rate |
$143.37 |
| Max. Negotiated Rate |
$257.16 |
| Rate for Payer: Aetna Commercial |
$192.12
|
| Rate for Payer: Aetna Medicare |
$143.37
|
| Rate for Payer: BCBS MAPPO |
$143.37
|
| Rate for Payer: BCN Commercial |
$210.65
|
| Rate for Payer: BCN Medicare Advantage |
$143.37
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cofinity Commercial |
$192.12
|
| Rate for Payer: Cofinity Commercial |
$206.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.37
|
| Rate for Payer: Healthscope Commercial |
$157.71
|
| Rate for Payer: Healthscope Whirlpool |
$157.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.71
|
| Rate for Payer: Nomi Health Commercial |
$172.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.00
|
| Rate for Payer: PACE SWMI |
$143.37
|
| Rate for Payer: PHP Medicare Advantage |
$143.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$189.48
|
| Rate for Payer: Priority Health Medicare |
$143.37
|
| Rate for Payer: Priority Health Narrow Network |
$189.48
|
| Rate for Payer: Railroad Medicare Medicare |
$143.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.37
|
| Rate for Payer: UHC Exchange |
$257.16
|
| Rate for Payer: UHCCP DNSP |
$143.37
|
|
|
PR HOME/RES VISIT NEW PATIENT SF MDM 15 MINUTES
|
Professional
|
Both
|
$134.00
|
|
|
Service Code
|
HCPCS 99341
|
| Min. Negotiated Rate |
$48.02 |
| Max. Negotiated Rate |
$100.50 |
| Rate for Payer: Aetna Commercial |
$64.35
|
| Rate for Payer: Aetna Medicare |
$48.02
|
| Rate for Payer: BCBS MAPPO |
$48.02
|
| Rate for Payer: BCN Commercial |
$73.20
|
| Rate for Payer: BCN Medicare Advantage |
$48.02
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$69.15
|
| Rate for Payer: Cofinity Commercial |
$64.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.02
|
| Rate for Payer: Healthscope Commercial |
$52.82
|
| Rate for Payer: Healthscope Whirlpool |
$52.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.82
|
| Rate for Payer: Nomi Health Commercial |
$57.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.50
|
| Rate for Payer: PACE SWMI |
$48.02
|
| Rate for Payer: PHP Medicare Advantage |
$48.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.85
|
| Rate for Payer: Priority Health Medicare |
$48.02
|
| Rate for Payer: Priority Health Narrow Network |
$65.85
|
| Rate for Payer: Railroad Medicare Medicare |
$48.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.02
|
| Rate for Payer: UHC Exchange |
$76.82
|
| Rate for Payer: UHCCP DNSP |
$48.02
|
|
|
PR HOME SLEEP TEST/TYPE 3 PORTA
|
Professional
|
Both
|
$366.00
|
|
|
Service Code
|
HCPCS G0399
|
| Min. Negotiated Rate |
$131.80 |
| Max. Negotiated Rate |
$328.38 |
| Rate for Payer: Aetna Commercial |
$187.42
|
| Rate for Payer: BCBS Complete |
$146.40
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$131.80
|
| Rate for Payer: Priority Health Narrow Network |
$131.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.38
|
| Rate for Payer: UHC Exchange |
$328.38
|
|
|
PR HOME SLEEP TEST/TYPE 4 PORTA
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS G0400
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$328.38 |
| Rate for Payer: Aetna Commercial |
$162.24
|
| Rate for Payer: Aetna Commercial |
$162.24
|
| Rate for Payer: Aetna Commercial |
$162.24
|
| Rate for Payer: BCBS Complete |
$86.00
|
| Rate for Payer: BCBS Complete |
$146.40
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$157.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$157.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$157.07
|
| Rate for Payer: Priority Health Narrow Network |
$157.07
|
| Rate for Payer: Priority Health Narrow Network |
$157.07
|
| Rate for Payer: Priority Health Narrow Network |
$157.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.38
|
| Rate for Payer: UHC Exchange |
$328.38
|
| Rate for Payer: UHC Exchange |
$328.38
|
| Rate for Payer: UHC Exchange |
$328.38
|
|
|
PR HOME VENTILATOR MGMT CARE OVERSIGHT 30 MIN/>
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 94005
|
| Min. Negotiated Rate |
$78.80 |
| Max. Negotiated Rate |
$147.77 |
| Rate for Payer: Aetna Commercial |
$100.62
|
| Rate for Payer: BCBS Complete |
$78.80
|
| Rate for Payer: BCN Commercial |
$134.95
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$124.46
|
| Rate for Payer: Priority Health Narrow Network |
$124.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$147.77
|
| Rate for Payer: UHC Exchange |
$147.77
|
|
|
PR HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 99343
|
| Min. Negotiated Rate |
$98.40 |
| Max. Negotiated Rate |
$184.50 |
| Rate for Payer: BCBS Complete |
$98.40
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.50
|
|
|
PR HOPD MNTL HLT, 15-29 MIN
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS C7900
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
|
|
PR HOPD MNTL HLT, 30-60 MIN
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS C7901
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
|
|
PR HOPD MNTL HLT, EA ADDL
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS C7902
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
|
|
PR HOSPICE CARE SUPERVISION
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS G0182
|
| Min. Negotiated Rate |
$78.80 |
| Max. Negotiated Rate |
$170.71 |
| Rate for Payer: Aetna Commercial |
$140.70
|
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: BCBS Complete |
$78.80
|
| Rate for Payer: BCBS MAPPO |
$105.00
|
| Rate for Payer: BCN Commercial |
$155.37
|
| Rate for Payer: BCN Medicare Advantage |
$105.00
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$151.20
|
| Rate for Payer: Cofinity Commercial |
$140.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.00
|
| Rate for Payer: Healthscope Commercial |
$126.00
|
| Rate for Payer: Healthscope Whirlpool |
$126.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.50
|
| Rate for Payer: Nomi Health Commercial |
$126.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.75
|
| Rate for Payer: PACE SWMI |
$105.00
|
| Rate for Payer: PHP Medicare Advantage |
$105.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.28
|
| Rate for Payer: Priority Health Medicare |
$105.00
|
| Rate for Payer: Priority Health Narrow Network |
$143.28
|
| Rate for Payer: Railroad Medicare Medicare |
$105.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$105.00
|
| Rate for Payer: UHC Exchange |
$170.71
|
| Rate for Payer: UHCCP DNSP |
$105.00
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 99236
|
| Min. Negotiated Rate |
$120.98 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$252.32
|
| Rate for Payer: Aetna Medicare |
$188.30
|
| Rate for Payer: BCBS Complete |
$127.03
|
| Rate for Payer: BCBS MAPPO |
$188.30
|
| Rate for Payer: BCN Commercial |
$307.25
|
| Rate for Payer: BCN Medicare Advantage |
$188.30
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$271.15
|
| Rate for Payer: Cofinity Commercial |
$252.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.30
|
| Rate for Payer: Healthscope Commercial |
$207.13
|
| Rate for Payer: Healthscope Whirlpool |
$207.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.72
|
| Rate for Payer: Meridian Medicaid |
$127.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$207.13
|
| Rate for Payer: Nomi Health Commercial |
$225.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.00
|
| Rate for Payer: PACE SWMI |
$188.30
|
| Rate for Payer: PHP Medicare Advantage |
$188.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$276.38
|
| Rate for Payer: Priority Health Medicare |
$188.30
|
| Rate for Payer: Priority Health Narrow Network |
$276.38
|
| Rate for Payer: Railroad Medicare Medicare |
$188.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$307.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$188.30
|
| Rate for Payer: UHC Exchange |
$307.50
|
| Rate for Payer: UHC Medicaid |
$120.98
|
| Rate for Payer: UHCCP DNSP |
$188.30
|
| Rate for Payer: UHCCP Medicaid |
$120.98
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 99235
|
| Min. Negotiated Rate |
$91.16 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Commercial |
$189.93
|
| Rate for Payer: Aetna Medicare |
$141.74
|
| Rate for Payer: BCBS Complete |
$95.72
|
| Rate for Payer: BCBS MAPPO |
$141.74
|
| Rate for Payer: BCN Commercial |
$235.05
|
| Rate for Payer: BCN Medicare Advantage |
$141.74
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$204.11
|
| Rate for Payer: Cofinity Commercial |
$189.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.74
|
| Rate for Payer: Healthscope Commercial |
$155.91
|
| Rate for Payer: Healthscope Whirlpool |
$155.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.83
|
| Rate for Payer: Meridian Medicaid |
$95.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$155.91
|
| Rate for Payer: Nomi Health Commercial |
$170.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$141.74
|
| Rate for Payer: PHP Medicare Advantage |
$141.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$211.43
|
| Rate for Payer: Priority Health Medicare |
$141.74
|
| Rate for Payer: Priority Health Narrow Network |
$211.43
|
| Rate for Payer: Railroad Medicare Medicare |
$141.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$238.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$141.74
|
| Rate for Payer: UHC Exchange |
$238.77
|
| Rate for Payer: UHC Medicaid |
$91.16
|
| Rate for Payer: UHCCP DNSP |
$141.74
|
| Rate for Payer: UHCCP Medicaid |
$91.16
|
|
