|
PR I&D INTRAMURAL IM/SUBMUCOSAL ABSC TRANSANAL ANES
|
Professional
|
Both
|
$758.00
|
|
|
Service Code
|
HCPCS 46045
|
| Min. Negotiated Rate |
$285.42 |
| Max. Negotiated Rate |
$813.05 |
| Rate for Payer: Aetna Commercial |
$581.92
|
| Rate for Payer: Aetna Medicare |
$434.27
|
| Rate for Payer: BCBS Complete |
$299.69
|
| Rate for Payer: BCBS MAPPO |
$434.27
|
| Rate for Payer: BCN Commercial |
$667.29
|
| Rate for Payer: BCN Medicare Advantage |
$434.27
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cofinity Commercial |
$625.35
|
| Rate for Payer: Cofinity Commercial |
$581.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.27
|
| Rate for Payer: Healthscope Commercial |
$521.12
|
| Rate for Payer: Healthscope Whirlpool |
$521.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.98
|
| Rate for Payer: Meridian Medicaid |
$299.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$477.70
|
| Rate for Payer: Nomi Health Commercial |
$521.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$568.50
|
| Rate for Payer: PACE SWMI |
$434.27
|
| Rate for Payer: PHP Medicare Advantage |
$434.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$813.05
|
| Rate for Payer: Priority Health Medicare |
$434.27
|
| Rate for Payer: Priority Health Narrow Network |
$813.05
|
| Rate for Payer: Railroad Medicare Medicare |
$434.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$764.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$434.27
|
| Rate for Payer: UHC Exchange |
$764.92
|
| Rate for Payer: UHC Medicaid |
$285.42
|
| Rate for Payer: UHCCP DNSP |
$434.27
|
| Rate for Payer: UHCCP Medicaid |
$285.42
|
|
|
PR I&D ISCHIORECTAL/INTRAMURAL ABSC W/WO SETON
|
Professional
|
Both
|
$2,191.00
|
|
|
Service Code
|
HCPCS 46060
|
| Min. Negotiated Rate |
$313.54 |
| Max. Negotiated Rate |
$1,643.25 |
| Rate for Payer: Aetna Commercial |
$637.29
|
| Rate for Payer: Aetna Medicare |
$475.59
|
| Rate for Payer: BCBS Complete |
$329.22
|
| Rate for Payer: BCBS MAPPO |
$475.59
|
| Rate for Payer: BCN Commercial |
$740.50
|
| Rate for Payer: BCN Medicare Advantage |
$475.59
|
| Rate for Payer: Cash Price |
$1,752.80
|
| Rate for Payer: Cash Price |
$1,752.80
|
| Rate for Payer: Cofinity Commercial |
$684.85
|
| Rate for Payer: Cofinity Commercial |
$637.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.59
|
| Rate for Payer: Healthscope Commercial |
$570.71
|
| Rate for Payer: Healthscope Whirlpool |
$570.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$499.37
|
| Rate for Payer: Meridian Medicaid |
$329.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$523.15
|
| Rate for Payer: Nomi Health Commercial |
$570.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,643.25
|
| Rate for Payer: PACE SWMI |
$475.59
|
| Rate for Payer: PHP Medicare Advantage |
$475.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$902.24
|
| Rate for Payer: Priority Health Medicare |
$475.59
|
| Rate for Payer: Priority Health Narrow Network |
$902.24
|
| Rate for Payer: Railroad Medicare Medicare |
$475.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$839.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$475.59
|
| Rate for Payer: UHC Exchange |
$839.31
|
| Rate for Payer: UHC Medicaid |
$313.54
|
| Rate for Payer: UHCCP DNSP |
$475.59
|
| Rate for Payer: UHCCP Medicaid |
$313.54
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
IP
|
$952.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$952.00 |
| Rate for Payer: Aetna Commercial |
$856.80
|
| Rate for Payer: ASR ASR |
$923.44
|
| Rate for Payer: BCBS Trust/PPO |
$781.78
|
| Rate for Payer: BCN Commercial |
$781.78
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$894.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.60
|
| Rate for Payer: Healthscope Commercial |
$923.44
|
| Rate for Payer: Healthscope Whirlpool |
$952.00
|
| Rate for Payer: Mclaren Commercial |
$856.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.20
|
| Rate for Payer: Nomi Health Commercial |
$780.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
46040
|
| Min. Negotiated Rate |
$277.33 |
| Max. Negotiated Rate |
$792.43 |
| Rate for Payer: Aetna Commercial |
$564.05
|
| Rate for Payer: Aetna Medicare |
$420.93
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$420.93
|
| Rate for Payer: BCN Commercial |
$650.37
|
| Rate for Payer: BCN Medicare Advantage |
$420.93
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$606.14
|
| Rate for Payer: Cofinity Commercial |
$564.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.93
|
| Rate for Payer: Healthscope Commercial |
$505.12
|
| Rate for Payer: Healthscope Whirlpool |
$505.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.98
|
| Rate for Payer: Meridian Medicaid |
$291.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$463.02
|
| Rate for Payer: Nomi Health Commercial |
$505.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE SWMI |
$420.93
|
| Rate for Payer: PHP Medicare Advantage |
$420.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$792.43
|
| Rate for Payer: Priority Health Medicare |
$420.93
|
| Rate for Payer: Priority Health Narrow Network |
$792.43
|
| Rate for Payer: Railroad Medicare Medicare |
$420.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$733.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$420.93
|
| Rate for Payer: UHC Exchange |
$733.32
|
| Rate for Payer: UHC Medicaid |
$277.33
|
| Rate for Payer: UHCCP DNSP |
$420.93
|
| Rate for Payer: UHCCP Medicaid |
$277.33
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 46040
|
| Min. Negotiated Rate |
$277.33 |
| Max. Negotiated Rate |
$792.43 |
| Rate for Payer: Aetna Commercial |
$564.05
|
| Rate for Payer: Aetna Medicare |
$420.93
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$420.93
|
| Rate for Payer: BCN Commercial |
$650.37
|
| Rate for Payer: BCN Medicare Advantage |
$420.93
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$606.14
|
| Rate for Payer: Cofinity Commercial |
$564.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.93
|
| Rate for Payer: Healthscope Commercial |
$505.12
|
| Rate for Payer: Healthscope Whirlpool |
$505.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.98
|
| Rate for Payer: Meridian Medicaid |
$291.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$463.02
|
| Rate for Payer: Nomi Health Commercial |
$505.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE SWMI |
$420.93
|
| Rate for Payer: PHP Medicare Advantage |
$420.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$792.43
|
| Rate for Payer: Priority Health Medicare |
$420.93
|
| Rate for Payer: Priority Health Narrow Network |
$792.43
|
| Rate for Payer: Railroad Medicare Medicare |
$420.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$733.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$420.93
|
| Rate for Payer: UHC Exchange |
$733.32
|
| Rate for Payer: UHC Medicaid |
$277.33
|
| Rate for Payer: UHCCP DNSP |
$420.93
|
| Rate for Payer: UHCCP Medicaid |
$277.33
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
OP
|
$952.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$4,060.21 |
| Rate for Payer: Aetna Commercial |
$856.80
|
| Rate for Payer: Aetna Medicare |
$1,192.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: ASR ASR |
$923.44
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$784.92
|
| Rate for Payer: BCN Commercial |
$784.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$894.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$923.44
|
| Rate for Payer: Healthscope Whirlpool |
$952.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,192.34
|
| Rate for Payer: Mclaren Commercial |
$856.80
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$654.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.20
|
| Rate for Payer: Nomi Health Commercial |
$780.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$1,311.57
|
| Rate for Payer: PHP Medicaid |
$639.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,060.21
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Narrow Network |
$3,248.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP DNSP |
$1,192.34
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
PR I&D OF BARTHOLINS GLAND ABSCESS
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 56420
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$298.50 |
| Rate for Payer: Aetna Commercial |
$130.36
|
| Rate for Payer: Aetna Medicare |
$97.28
|
| Rate for Payer: BCBS Complete |
$67.09
|
| Rate for Payer: BCBS MAPPO |
$97.28
|
| Rate for Payer: BCN Commercial |
$165.33
|
| Rate for Payer: BCN Medicare Advantage |
$97.28
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$140.08
|
| Rate for Payer: Cofinity Commercial |
$130.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.28
|
| Rate for Payer: Healthscope Commercial |
$116.74
|
| Rate for Payer: Healthscope Whirlpool |
$116.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.14
|
| Rate for Payer: Meridian Medicaid |
$67.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.01
|
| Rate for Payer: Nomi Health Commercial |
$116.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.50
|
| Rate for Payer: PACE SWMI |
$97.28
|
| Rate for Payer: PHP Medicare Advantage |
$97.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$167.44
|
| Rate for Payer: Priority Health Medicare |
$97.28
|
| Rate for Payer: Priority Health Narrow Network |
$167.44
|
| Rate for Payer: Railroad Medicare Medicare |
$97.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.28
|
| Rate for Payer: UHC Exchange |
$179.66
|
| Rate for Payer: UHC Medicaid |
$63.90
|
| Rate for Payer: UHCCP DNSP |
$97.28
|
| Rate for Payer: UHCCP Medicaid |
$63.90
|
|
|
PR I&D PELVIS/HIP JOINT AREA INFECTED BURSA
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 26991
|
| Min. Negotiated Rate |
$313.54 |
| Max. Negotiated Rate |
$960.75 |
| Rate for Payer: Aetna Commercial |
$641.93
|
| Rate for Payer: Aetna Medicare |
$479.05
|
| Rate for Payer: BCBS Complete |
$329.22
|
| Rate for Payer: BCBS MAPPO |
$479.05
|
| Rate for Payer: BCN Commercial |
$799.26
|
| Rate for Payer: BCN Medicare Advantage |
$479.05
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cofinity Commercial |
$689.83
|
| Rate for Payer: Cofinity Commercial |
$641.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.05
|
| Rate for Payer: Healthscope Commercial |
$574.86
|
| Rate for Payer: Healthscope Whirlpool |
$574.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$503.00
|
| Rate for Payer: Meridian Medicaid |
$329.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$526.96
|
| Rate for Payer: Nomi Health Commercial |
$574.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.75
|
| Rate for Payer: PACE SWMI |
$479.05
|
| Rate for Payer: PHP Medicare Advantage |
$479.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$854.38
|
| Rate for Payer: Priority Health Medicare |
$479.05
|
| Rate for Payer: Priority Health Narrow Network |
$854.38
|
| Rate for Payer: Railroad Medicare Medicare |
$479.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$916.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$479.05
|
| Rate for Payer: UHC Exchange |
$916.20
|
| Rate for Payer: UHC Medicaid |
$313.54
|
| Rate for Payer: UHCCP DNSP |
$479.05
|
| Rate for Payer: UHCCP Medicaid |
$313.54
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,558.00
|
|
|
Service Code
|
HCPCS 26990
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$1,168.50 |
| Rate for Payer: Aetna Commercial |
$854.69
|
| Rate for Payer: Aetna Medicare |
$637.83
|
| Rate for Payer: BCBS Complete |
$442.38
|
| Rate for Payer: BCBS MAPPO |
$637.83
|
| Rate for Payer: BCN Commercial |
$1,031.31
|
| Rate for Payer: BCN Medicare Advantage |
$637.83
|
| Rate for Payer: Cash Price |
$1,246.40
|
| Rate for Payer: Cash Price |
$1,246.40
|
| Rate for Payer: Cofinity Commercial |
$918.48
|
| Rate for Payer: Cofinity Commercial |
$854.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.83
|
| Rate for Payer: Healthscope Commercial |
$765.40
|
| Rate for Payer: Healthscope Whirlpool |
$765.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.72
|
| Rate for Payer: Meridian Medicaid |
$442.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$701.61
|
| Rate for Payer: Nomi Health Commercial |
$765.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,168.50
|
| Rate for Payer: PACE SWMI |
$637.83
|
| Rate for Payer: PHP Medicare Advantage |
$637.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$421.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,102.46
|
| Rate for Payer: Priority Health Medicare |
$637.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,102.46
|
| Rate for Payer: Railroad Medicare Medicare |
$637.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,135.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$637.83
|
| Rate for Payer: UHC Exchange |
$1,135.16
|
| Rate for Payer: UHC Medicaid |
$421.31
|
| Rate for Payer: UHCCP DNSP |
$637.83
|
| Rate for Payer: UHCCP Medicaid |
$421.31
|
|
|
PR I&D PENIS DEEP
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 54015
|
| Min. Negotiated Rate |
$176.79 |
| Max. Negotiated Rate |
$591.75 |
| Rate for Payer: Aetna Commercial |
$365.91
|
| Rate for Payer: Aetna Medicare |
$273.07
|
| Rate for Payer: BCBS Complete |
$185.63
|
| Rate for Payer: BCBS MAPPO |
$273.07
|
| Rate for Payer: BCN Commercial |
$456.15
|
| Rate for Payer: BCN Medicare Advantage |
$273.07
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$393.22
|
| Rate for Payer: Cofinity Commercial |
$365.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.07
|
| Rate for Payer: Healthscope Commercial |
$327.68
|
| Rate for Payer: Healthscope Whirlpool |
$327.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.72
|
| Rate for Payer: Meridian Medicaid |
$185.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.38
|
| Rate for Payer: Nomi Health Commercial |
$327.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.75
|
| Rate for Payer: PACE SWMI |
$273.07
|
| Rate for Payer: PHP Medicare Advantage |
$273.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$496.89
|
| Rate for Payer: Priority Health Medicare |
$273.07
|
| Rate for Payer: Priority Health Narrow Network |
$496.89
|
| Rate for Payer: Railroad Medicare Medicare |
$273.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$539.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$273.07
|
| Rate for Payer: UHC Exchange |
$539.24
|
| Rate for Payer: UHC Medicaid |
$176.79
|
| Rate for Payer: UHCCP DNSP |
$273.07
|
| Rate for Payer: UHCCP Medicaid |
$176.79
|
|
|
PR I&D PERIANAL ABSCESS SUPERFICIAL
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 46050
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$348.00 |
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna Medicare |
$99.78
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS MAPPO |
$99.78
|
| Rate for Payer: BCN Commercial |
$154.38
|
| Rate for Payer: BCN Medicare Advantage |
$99.78
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cofinity Commercial |
$143.68
|
| Rate for Payer: Cofinity Commercial |
$133.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.78
|
| Rate for Payer: Healthscope Commercial |
$119.74
|
| Rate for Payer: Healthscope Whirlpool |
$119.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.77
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.76
|
| Rate for Payer: Nomi Health Commercial |
$119.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$348.00
|
| Rate for Payer: PACE SWMI |
$99.78
|
| Rate for Payer: PHP Medicare Advantage |
$99.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$188.09
|
| Rate for Payer: Priority Health Medicare |
$99.78
|
| Rate for Payer: Priority Health Narrow Network |
$188.09
|
| Rate for Payer: Railroad Medicare Medicare |
$99.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.78
|
| Rate for Payer: UHC Exchange |
$171.69
|
| Rate for Payer: UHC Medicaid |
$66.03
|
| Rate for Payer: UHCCP DNSP |
$99.78
|
| Rate for Payer: UHCCP Medicaid |
$66.03
|
|
|
PR I&D SHOULDER DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 23030
|
| Min. Negotiated Rate |
$155.49 |
| Max. Negotiated Rate |
$552.75 |
| Rate for Payer: Aetna Commercial |
$318.24
|
| Rate for Payer: Aetna Medicare |
$237.49
|
| Rate for Payer: BCBS Complete |
$163.26
|
| Rate for Payer: BCBS MAPPO |
$237.49
|
| Rate for Payer: BCN Commercial |
$388.43
|
| Rate for Payer: BCN Medicare Advantage |
$237.49
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Commercial |
$341.99
|
| Rate for Payer: Cofinity Commercial |
$318.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.49
|
| Rate for Payer: Healthscope Commercial |
$284.99
|
| Rate for Payer: Healthscope Whirlpool |
$284.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.36
|
| Rate for Payer: Meridian Medicaid |
$163.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.24
|
| Rate for Payer: Nomi Health Commercial |
$284.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
| Rate for Payer: PACE SWMI |
$237.49
|
| Rate for Payer: PHP Medicare Advantage |
$237.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$415.21
|
| Rate for Payer: Priority Health Medicare |
$237.49
|
| Rate for Payer: Priority Health Narrow Network |
$415.21
|
| Rate for Payer: Railroad Medicare Medicare |
$237.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$434.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.49
|
| Rate for Payer: UHC Exchange |
$434.39
|
| Rate for Payer: UHC Medicaid |
$155.49
|
| Rate for Payer: UHCCP DNSP |
$237.49
|
| Rate for Payer: UHCCP Medicaid |
$155.49
|
|
|
PR I&D SHOULDER INFECTED BURSA
|
Professional
|
Both
|
$742.00
|
|
|
Service Code
|
HCPCS 23031
|
| Min. Negotiated Rate |
$137.60 |
| Max. Negotiated Rate |
$556.50 |
| Rate for Payer: Aetna Commercial |
$280.07
|
| Rate for Payer: Aetna Medicare |
$209.01
|
| Rate for Payer: BCBS Complete |
$144.48
|
| Rate for Payer: BCBS MAPPO |
$209.01
|
| Rate for Payer: BCN Commercial |
$341.12
|
| Rate for Payer: BCN Medicare Advantage |
$209.01
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cofinity Commercial |
$280.07
|
| Rate for Payer: Cofinity Commercial |
$300.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.01
|
| Rate for Payer: Healthscope Commercial |
$250.81
|
| Rate for Payer: Healthscope Whirlpool |
$250.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.46
|
| Rate for Payer: Meridian Medicaid |
$144.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.91
|
| Rate for Payer: Nomi Health Commercial |
$250.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$556.50
|
| Rate for Payer: PACE SWMI |
$209.01
|
| Rate for Payer: PHP Medicare Advantage |
$209.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$364.64
|
| Rate for Payer: Priority Health Medicare |
$209.01
|
| Rate for Payer: Priority Health Narrow Network |
$364.64
|
| Rate for Payer: Railroad Medicare Medicare |
$209.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$209.01
|
| Rate for Payer: UHC Exchange |
$362.70
|
| Rate for Payer: UHC Medicaid |
$137.60
|
| Rate for Payer: UHCCP DNSP |
$209.01
|
| Rate for Payer: UHCCP Medicaid |
$137.60
|
|
|
PR I&D SOFT TISSUE ABSCESS SUBFASCIAL
|
Professional
|
Both
|
$530.00
|
|
|
Service Code
|
HCPCS 20005
|
| Min. Negotiated Rate |
$212.00 |
| Max. Negotiated Rate |
$397.50 |
| Rate for Payer: BCBS Complete |
$212.00
|
| Rate for Payer: Cash Price |
$424.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.50
|
|
|
PR I&D SUBMUCOSAL ABSCESS RECTUM
|
Professional
|
Both
|
$543.00
|
|
|
Service Code
|
HCPCS 45005
|
| Min. Negotiated Rate |
$110.76 |
| Max. Negotiated Rate |
$407.25 |
| Rate for Payer: Aetna Commercial |
$225.09
|
| Rate for Payer: Aetna Medicare |
$167.98
|
| Rate for Payer: BCBS Complete |
$116.30
|
| Rate for Payer: BCBS MAPPO |
$167.98
|
| Rate for Payer: BCN Commercial |
$254.97
|
| Rate for Payer: BCN Medicare Advantage |
$167.98
|
| Rate for Payer: Cash Price |
$434.40
|
| Rate for Payer: Cash Price |
$434.40
|
| Rate for Payer: Cofinity Commercial |
$241.89
|
| Rate for Payer: Cofinity Commercial |
$225.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.98
|
| Rate for Payer: Healthscope Commercial |
$201.58
|
| Rate for Payer: Healthscope Whirlpool |
$201.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.38
|
| Rate for Payer: Meridian Medicaid |
$116.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.78
|
| Rate for Payer: Nomi Health Commercial |
$201.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.25
|
| Rate for Payer: PACE SWMI |
$167.98
|
| Rate for Payer: PHP Medicare Advantage |
$167.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$310.65
|
| Rate for Payer: Priority Health Medicare |
$167.98
|
| Rate for Payer: Priority Health Narrow Network |
$310.65
|
| Rate for Payer: Railroad Medicare Medicare |
$167.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$282.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$167.98
|
| Rate for Payer: UHC Exchange |
$282.58
|
| Rate for Payer: UHC Medicaid |
$110.76
|
| Rate for Payer: UHCCP DNSP |
$167.98
|
| Rate for Payer: UHCCP Medicaid |
$110.76
|
|
|
PR I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$639.00
|
|
|
Service Code
|
HCPCS 23930
|
| Min. Negotiated Rate |
$130.78 |
| Max. Negotiated Rate |
$479.25 |
| Rate for Payer: Aetna Commercial |
$268.17
|
| Rate for Payer: Aetna Medicare |
$200.13
|
| Rate for Payer: BCBS Complete |
$137.32
|
| Rate for Payer: BCBS MAPPO |
$200.13
|
| Rate for Payer: BCN Commercial |
$329.17
|
| Rate for Payer: BCN Medicare Advantage |
$200.13
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cofinity Commercial |
$288.19
|
| Rate for Payer: Cofinity Commercial |
$268.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.13
|
| Rate for Payer: Healthscope Commercial |
$240.16
|
| Rate for Payer: Healthscope Whirlpool |
$240.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.14
|
| Rate for Payer: Meridian Medicaid |
$137.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.14
|
| Rate for Payer: Nomi Health Commercial |
$240.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.25
|
| Rate for Payer: PACE SWMI |
$200.13
|
| Rate for Payer: PHP Medicare Advantage |
$200.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$351.87
|
| Rate for Payer: Priority Health Medicare |
$200.13
|
| Rate for Payer: Priority Health Narrow Network |
$351.87
|
| Rate for Payer: Railroad Medicare Medicare |
$200.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$200.13
|
| Rate for Payer: UHC Exchange |
$370.60
|
| Rate for Payer: UHC Medicaid |
$130.78
|
| Rate for Payer: UHCCP DNSP |
$200.13
|
| Rate for Payer: UHCCP Medicaid |
$130.78
|
|
|
PR I&D VAGINAL HEMATOMA NON-OBSTETRICAL
|
Professional
|
Both
|
$542.00
|
|
|
Service Code
|
HCPCS 57023
|
| Min. Negotiated Rate |
$180.62 |
| Max. Negotiated Rate |
$558.24 |
| Rate for Payer: Aetna Commercial |
$374.78
|
| Rate for Payer: Aetna Medicare |
$279.69
|
| Rate for Payer: BCBS Complete |
$189.65
|
| Rate for Payer: BCBS MAPPO |
$279.69
|
| Rate for Payer: BCN Commercial |
$480.06
|
| Rate for Payer: BCN Medicare Advantage |
$279.69
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Cofinity Commercial |
$402.75
|
| Rate for Payer: Cofinity Commercial |
$374.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.69
|
| Rate for Payer: Healthscope Commercial |
$335.63
|
| Rate for Payer: Healthscope Whirlpool |
$335.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.67
|
| Rate for Payer: Meridian Medicaid |
$189.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$307.66
|
| Rate for Payer: Nomi Health Commercial |
$335.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$406.50
|
| Rate for Payer: PACE SWMI |
$279.69
|
| Rate for Payer: PHP Medicare Advantage |
$279.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$486.19
|
| Rate for Payer: Priority Health Medicare |
$279.69
|
| Rate for Payer: Priority Health Narrow Network |
$486.19
|
| Rate for Payer: Railroad Medicare Medicare |
$279.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$558.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$279.69
|
| Rate for Payer: UHC Exchange |
$558.24
|
| Rate for Payer: UHC Medicaid |
$180.62
|
| Rate for Payer: UHCCP DNSP |
$279.69
|
| Rate for Payer: UHCCP Medicaid |
$180.62
|
|
|
PR I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 57022
|
| Min. Negotiated Rate |
$101.81 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Aetna Commercial |
$210.13
|
| Rate for Payer: Aetna Medicare |
$156.81
|
| Rate for Payer: BCBS Complete |
$106.90
|
| Rate for Payer: BCBS MAPPO |
$156.81
|
| Rate for Payer: BCN Commercial |
$272.89
|
| Rate for Payer: BCN Medicare Advantage |
$156.81
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$225.81
|
| Rate for Payer: Cofinity Commercial |
$210.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.81
|
| Rate for Payer: Healthscope Commercial |
$188.17
|
| Rate for Payer: Healthscope Whirlpool |
$188.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.65
|
| Rate for Payer: Meridian Medicaid |
$106.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.49
|
| Rate for Payer: Nomi Health Commercial |
$188.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.00
|
| Rate for Payer: PACE SWMI |
$156.81
|
| Rate for Payer: PHP Medicare Advantage |
$156.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$276.38
|
| Rate for Payer: Priority Health Medicare |
$156.81
|
| Rate for Payer: Priority Health Narrow Network |
$276.38
|
| Rate for Payer: Railroad Medicare Medicare |
$156.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$156.81
|
| Rate for Payer: UHC Exchange |
$309.93
|
| Rate for Payer: UHC Medicaid |
$101.81
|
| Rate for Payer: UHCCP DNSP |
$156.81
|
| Rate for Payer: UHCCP Medicaid |
$101.81
|
|
|
PR I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$286.00
|
|
|
Service Code
|
HCPCS 56405
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Commercial |
$151.18
|
| Rate for Payer: Aetna Medicare |
$112.82
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$112.82
|
| Rate for Payer: BCN Commercial |
$191.72
|
| Rate for Payer: BCN Medicare Advantage |
$112.82
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cofinity Commercial |
$162.46
|
| Rate for Payer: Cofinity Commercial |
$151.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.82
|
| Rate for Payer: Healthscope Commercial |
$135.38
|
| Rate for Payer: Healthscope Whirlpool |
$135.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.46
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$124.10
|
| Rate for Payer: Nomi Health Commercial |
$135.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.50
|
| Rate for Payer: PACE SWMI |
$112.82
|
| Rate for Payer: PHP Medicare Advantage |
$112.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$194.17
|
| Rate for Payer: Priority Health Medicare |
$112.82
|
| Rate for Payer: Priority Health Narrow Network |
$194.17
|
| Rate for Payer: Railroad Medicare Medicare |
$112.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.82
|
| Rate for Payer: UHC Exchange |
$206.40
|
| Rate for Payer: UHC Medicaid |
$74.55
|
| Rate for Payer: UHCCP DNSP |
$112.82
|
| Rate for Payer: UHCCP Medicaid |
$74.55
|
|
|
PR IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 90657
|
| Min. Negotiated Rate |
$9.74 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Aetna Commercial |
$14.78
|
| Rate for Payer: Aetna Medicare |
$11.03
|
| Rate for Payer: BCBS MAPPO |
$11.03
|
| Rate for Payer: BCBS Trust/PPO |
$9.74
|
| Rate for Payer: BCN Commercial |
$9.75
|
| Rate for Payer: BCN Medicare Advantage |
$11.03
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$14.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.03
|
| Rate for Payer: Healthscope Commercial |
$13.24
|
| Rate for Payer: Healthscope Whirlpool |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.13
|
| Rate for Payer: Nomi Health Commercial |
$13.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$11.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.03
|
| Rate for Payer: Priority Health Medicare |
$11.03
|
| Rate for Payer: Railroad Medicare Medicare |
$11.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.03
|
| Rate for Payer: UHC Exchange |
$10.06
|
| Rate for Payer: UHCCP DNSP |
$11.03
|
|
|
PR IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 90658
|
| Min. Negotiated Rate |
$19.48 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Aetna Commercial |
$29.57
|
| Rate for Payer: Aetna Medicare |
$22.07
|
| Rate for Payer: BCBS MAPPO |
$22.07
|
| Rate for Payer: BCBS Trust/PPO |
$19.48
|
| Rate for Payer: BCN Commercial |
$19.51
|
| Rate for Payer: BCN Medicare Advantage |
$22.07
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$31.78
|
| Rate for Payer: Cofinity Commercial |
$29.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.07
|
| Rate for Payer: Healthscope Commercial |
$26.48
|
| Rate for Payer: Healthscope Whirlpool |
$26.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.28
|
| Rate for Payer: Nomi Health Commercial |
$26.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$22.07
|
| Rate for Payer: PHP Medicare Advantage |
$22.07
|
| Rate for Payer: Priority Health Medicare |
$22.07
|
| Rate for Payer: Railroad Medicare Medicare |
$22.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.07
|
| Rate for Payer: UHC Exchange |
$20.11
|
| Rate for Payer: UHCCP DNSP |
$22.07
|
|
|
PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 90656
|
| Min. Negotiated Rate |
$20.49 |
| Max. Negotiated Rate |
$33.44 |
| Rate for Payer: Aetna Commercial |
$31.11
|
| Rate for Payer: Aetna Medicare |
$23.22
|
| Rate for Payer: BCBS MAPPO |
$23.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.49
|
| Rate for Payer: BCN Commercial |
$21.12
|
| Rate for Payer: BCN Medicare Advantage |
$23.22
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$33.44
|
| Rate for Payer: Cofinity Commercial |
$31.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.22
|
| Rate for Payer: Healthscope Commercial |
$27.86
|
| Rate for Payer: Healthscope Whirlpool |
$27.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.54
|
| Rate for Payer: Nomi Health Commercial |
$27.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$23.22
|
| Rate for Payer: PHP Medicare Advantage |
$23.22
|
| Rate for Payer: Priority Health Medicare |
$23.22
|
| Rate for Payer: Railroad Medicare Medicare |
$23.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.22
|
| Rate for Payer: UHC Exchange |
$21.07
|
| Rate for Payer: UHCCP DNSP |
$23.22
|
|
|
PR IIV3 VACC PRESRV FREE 0.25 ML DOSAGE IM USE
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 90655
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna Commercial |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$20.49
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.38
|
| Rate for Payer: UHC Exchange |
$13.38
|
|
|
PR IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 90686
|
| Min. Negotiated Rate |
$19.73 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Aetna Commercial |
$22.35
|
| Rate for Payer: BCBS Trust/PPO |
$19.73
|
| Rate for Payer: BCN Commercial |
$22.65
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.35
|
| Rate for Payer: UHC Exchange |
$22.35
|
|
|
PR IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 90685
|
| Min. Negotiated Rate |
$19.36 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$19.36
|
| Rate for Payer: BCBS Trust/PPO |
$22.05
|
| Rate for Payer: BCN Commercial |
$22.05
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.78
|
| Rate for Payer: UHC Exchange |
$22.78
|
|
