|
PR IMMUNIZE COUNSEL 5-15 MIN
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS G0310
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
|
|
PR IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 15778
|
| Min. Negotiated Rate |
$320.80 |
| Max. Negotiated Rate |
$549.23 |
| Rate for Payer: Aetna Commercial |
$511.09
|
| Rate for Payer: Aetna Medicare |
$381.41
|
| Rate for Payer: BCBS Complete |
$320.80
|
| Rate for Payer: BCBS MAPPO |
$381.41
|
| Rate for Payer: BCN Medicare Advantage |
$381.41
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cofinity Commercial |
$511.09
|
| Rate for Payer: Cofinity Commercial |
$549.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.41
|
| Rate for Payer: Healthscope Commercial |
$457.69
|
| Rate for Payer: Healthscope Whirlpool |
$457.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.48
|
| Rate for Payer: Nomi Health Commercial |
$457.69
|
| Rate for Payer: PACE SWMI |
$381.41
|
| Rate for Payer: PHP Medicare Advantage |
$381.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.30
|
| Rate for Payer: Priority Health Medicare |
$381.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$381.41
|
| Rate for Payer: UHC Medicare Advantage |
$381.41
|
| Rate for Payer: UHCCP DNSP |
$381.41
|
|
|
PR IMPLANTABLE TISSUE MARKER
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS A4648
|
| Min. Negotiated Rate |
$489.60 |
| Max. Negotiated Rate |
$795.60 |
| Rate for Payer: Aetna Medicare |
$612.00
|
| Rate for Payer: BCBS Complete |
$489.60
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.60
|
|
|
PR IMPLANTATION NERVE END BONE/MUSCLE
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 64787
|
| Min. Negotiated Rate |
$225.69 |
| Max. Negotiated Rate |
$1,204.45 |
| Rate for Payer: Aetna Commercial |
$302.42
|
| Rate for Payer: Aetna Medicare |
$225.69
|
| Rate for Payer: BCBS Complete |
$741.20
|
| Rate for Payer: BCBS MAPPO |
$225.69
|
| Rate for Payer: BCN Medicare Advantage |
$225.69
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$324.99
|
| Rate for Payer: Cofinity Commercial |
$302.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.69
|
| Rate for Payer: Healthscope Commercial |
$270.83
|
| Rate for Payer: Healthscope Whirlpool |
$270.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.97
|
| Rate for Payer: Nomi Health Commercial |
$270.83
|
| Rate for Payer: PACE SWMI |
$225.69
|
| Rate for Payer: PHP Medicare Advantage |
$225.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health Medicare |
$225.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.69
|
| Rate for Payer: UHC Medicare Advantage |
$225.69
|
| Rate for Payer: UHCCP DNSP |
$225.69
|
|
|
PR IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER
|
Professional
|
Both
|
$630.00
|
|
|
Service Code
|
HCPCS 33282
|
| Min. Negotiated Rate |
$252.00 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna Medicare |
$315.00
|
| Rate for Payer: BCBS Complete |
$252.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.50
|
|
|
PR IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE
|
Professional
|
Both
|
$1,010.00
|
|
|
Service Code
|
HCPCS 49568
|
| Min. Negotiated Rate |
$404.00 |
| Max. Negotiated Rate |
$656.50 |
| Rate for Payer: Aetna Medicare |
$505.00
|
| Rate for Payer: BCBS Complete |
$404.00
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.50
|
|
|
PR IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT
|
Professional
|
Both
|
$448.00
|
|
|
Service Code
|
HCPCS 15777
|
| Min. Negotiated Rate |
$179.20 |
| Max. Negotiated Rate |
$295.98 |
| Rate for Payer: Aetna Commercial |
$275.42
|
| Rate for Payer: Aetna Medicare |
$205.54
|
| Rate for Payer: BCBS Complete |
$179.20
|
| Rate for Payer: BCBS MAPPO |
$205.54
|
| Rate for Payer: BCN Medicare Advantage |
$205.54
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cofinity Commercial |
$295.98
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.54
|
| Rate for Payer: Healthscope Commercial |
$246.65
|
| Rate for Payer: Healthscope Whirlpool |
$246.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.82
|
| Rate for Payer: Nomi Health Commercial |
$246.65
|
| Rate for Payer: PACE SWMI |
$205.54
|
| Rate for Payer: PHP Medicare Advantage |
$205.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.20
|
| Rate for Payer: Priority Health Medicare |
$205.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.54
|
| Rate for Payer: UHC Medicare Advantage |
$205.54
|
| Rate for Payer: UHCCP DNSP |
$205.54
|
|
|
PR IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP<100
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 69716
|
| Min. Negotiated Rate |
$537.20 |
| Max. Negotiated Rate |
$872.95 |
| Rate for Payer: Aetna Commercial |
$787.60
|
| Rate for Payer: Aetna Medicare |
$587.76
|
| Rate for Payer: BCBS Complete |
$537.20
|
| Rate for Payer: BCBS MAPPO |
$587.76
|
| Rate for Payer: BCN Medicare Advantage |
$587.76
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$846.37
|
| Rate for Payer: Cofinity Commercial |
$787.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.76
|
| Rate for Payer: Healthscope Commercial |
$705.31
|
| Rate for Payer: Healthscope Whirlpool |
$705.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.15
|
| Rate for Payer: Nomi Health Commercial |
$705.31
|
| Rate for Payer: PACE SWMI |
$587.76
|
| Rate for Payer: PHP Medicare Advantage |
$587.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health Medicare |
$587.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.76
|
| Rate for Payer: UHC Medicare Advantage |
$587.76
|
| Rate for Payer: UHCCP DNSP |
$587.76
|
|
|
PR IMPL OI IMPLT SKULL PERQ ATTACHMENT ESP
|
Professional
|
Both
|
$1,953.00
|
|
|
Service Code
|
HCPCS 69714
|
| Min. Negotiated Rate |
$467.49 |
| Max. Negotiated Rate |
$1,269.45 |
| Rate for Payer: Aetna Commercial |
$626.44
|
| Rate for Payer: Aetna Medicare |
$467.49
|
| Rate for Payer: BCBS Complete |
$781.20
|
| Rate for Payer: BCBS MAPPO |
$467.49
|
| Rate for Payer: BCN Medicare Advantage |
$467.49
|
| Rate for Payer: Cash Price |
$1,562.40
|
| Rate for Payer: Cash Price |
$1,562.40
|
| Rate for Payer: Cofinity Commercial |
$673.19
|
| Rate for Payer: Cofinity Commercial |
$626.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.49
|
| Rate for Payer: Healthscope Commercial |
$560.99
|
| Rate for Payer: Healthscope Whirlpool |
$560.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.86
|
| Rate for Payer: Nomi Health Commercial |
$560.99
|
| Rate for Payer: PACE SWMI |
$467.49
|
| Rate for Payer: PHP Medicare Advantage |
$467.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,269.45
|
| Rate for Payer: Priority Health Medicare |
$467.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$467.49
|
| Rate for Payer: UHC Medicare Advantage |
$467.49
|
| Rate for Payer: UHCCP DNSP |
$467.49
|
|
|
PR IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT
|
Professional
|
Both
|
$419.00
|
|
|
Service Code
|
HCPCS 61517
|
| Min. Negotiated Rate |
$86.68 |
| Max. Negotiated Rate |
$272.35 |
| Rate for Payer: Aetna Commercial |
$116.15
|
| Rate for Payer: Aetna Medicare |
$86.68
|
| Rate for Payer: BCBS Complete |
$167.60
|
| Rate for Payer: BCBS MAPPO |
$86.68
|
| Rate for Payer: BCN Medicare Advantage |
$86.68
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cofinity Commercial |
$124.82
|
| Rate for Payer: Cofinity Commercial |
$116.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.68
|
| Rate for Payer: Healthscope Commercial |
$104.02
|
| Rate for Payer: Healthscope Whirlpool |
$104.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.01
|
| Rate for Payer: Nomi Health Commercial |
$104.02
|
| Rate for Payer: PACE SWMI |
$86.68
|
| Rate for Payer: PHP Medicare Advantage |
$86.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.35
|
| Rate for Payer: Priority Health Medicare |
$86.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.68
|
| Rate for Payer: UHC Medicare Advantage |
$86.68
|
| Rate for Payer: UHCCP DNSP |
$86.68
|
|
|
PR IMPLTJ NONBIOL/SYNTH IMPLT FASC RNFCMT ABDL WALL
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 0437T
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$318.50 |
| Rate for Payer: Aetna Medicare |
$245.00
|
| Rate for Payer: BCBS Complete |
$196.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.50
|
|
|
PR IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM
|
Professional
|
Both
|
$821.00
|
|
|
Service Code
|
HCPCS 62350
|
| Min. Negotiated Rate |
$328.40 |
| Max. Negotiated Rate |
$555.24 |
| Rate for Payer: Aetna Commercial |
$516.68
|
| Rate for Payer: Aetna Medicare |
$385.58
|
| Rate for Payer: BCBS Complete |
$328.40
|
| Rate for Payer: BCBS MAPPO |
$385.58
|
| Rate for Payer: BCN Medicare Advantage |
$385.58
|
| Rate for Payer: Cash Price |
$656.80
|
| Rate for Payer: Cash Price |
$656.80
|
| Rate for Payer: Cofinity Commercial |
$555.24
|
| Rate for Payer: Cofinity Commercial |
$516.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.58
|
| Rate for Payer: Healthscope Commercial |
$462.70
|
| Rate for Payer: Healthscope Whirlpool |
$462.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.86
|
| Rate for Payer: Nomi Health Commercial |
$462.70
|
| Rate for Payer: PACE SWMI |
$385.58
|
| Rate for Payer: PHP Medicare Advantage |
$385.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.65
|
| Rate for Payer: Priority Health Medicare |
$385.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$385.58
|
| Rate for Payer: UHC Medicare Advantage |
$385.58
|
| Rate for Payer: UHCCP DNSP |
$385.58
|
|
|
PR IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP
|
Professional
|
Both
|
$2,526.00
|
|
|
Service Code
|
HCPCS 62362
|
| Min. Negotiated Rate |
$373.09 |
| Max. Negotiated Rate |
$1,641.90 |
| Rate for Payer: Aetna Commercial |
$499.94
|
| Rate for Payer: Aetna Medicare |
$373.09
|
| Rate for Payer: BCBS Complete |
$1,010.40
|
| Rate for Payer: BCBS MAPPO |
$373.09
|
| Rate for Payer: BCN Medicare Advantage |
$373.09
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cofinity Commercial |
$537.25
|
| Rate for Payer: Cofinity Commercial |
$499.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.09
|
| Rate for Payer: Healthscope Commercial |
$447.71
|
| Rate for Payer: Healthscope Whirlpool |
$447.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.74
|
| Rate for Payer: Nomi Health Commercial |
$447.71
|
| Rate for Payer: PACE SWMI |
$373.09
|
| Rate for Payer: PHP Medicare Advantage |
$373.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.90
|
| Rate for Payer: Priority Health Medicare |
$373.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.09
|
| Rate for Payer: UHC Medicare Advantage |
$373.09
|
| Rate for Payer: UHCCP DNSP |
$373.09
|
|
|
PR IMPREG GAUZE NO H20/SAL/YARD
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS A6266
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$4.55 |
| Rate for Payer: Aetna Commercial |
$3.58
|
| Rate for Payer: Aetna Medicare |
$2.67
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$2.67
|
| Rate for Payer: BCN Medicare Advantage |
$2.67
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$3.84
|
| Rate for Payer: Cofinity Commercial |
$3.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.67
|
| Rate for Payer: Healthscope Commercial |
$3.20
|
| Rate for Payer: Healthscope Whirlpool |
$3.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.80
|
| Rate for Payer: Nomi Health Commercial |
$3.20
|
| Rate for Payer: PACE SWMI |
$2.67
|
| Rate for Payer: PHP Medicare Advantage |
$2.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.55
|
| Rate for Payer: Priority Health Medicare |
$2.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.67
|
| Rate for Payer: UHC Medicare Advantage |
$2.67
|
| Rate for Payer: UHCCP DNSP |
$2.67
|
|
|
PR INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW
|
Professional
|
Both
|
$1,497.00
|
|
|
Service Code
|
HCPCS 23935
|
| Min. Negotiated Rate |
$496.78 |
| Max. Negotiated Rate |
$973.05 |
| Rate for Payer: Aetna Commercial |
$665.69
|
| Rate for Payer: Aetna Medicare |
$496.78
|
| Rate for Payer: BCBS Complete |
$598.80
|
| Rate for Payer: BCBS MAPPO |
$496.78
|
| Rate for Payer: BCN Medicare Advantage |
$496.78
|
| Rate for Payer: Cash Price |
$1,197.60
|
| Rate for Payer: Cash Price |
$1,197.60
|
| Rate for Payer: Cofinity Commercial |
$715.36
|
| Rate for Payer: Cofinity Commercial |
$665.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.78
|
| Rate for Payer: Healthscope Commercial |
$596.14
|
| Rate for Payer: Healthscope Whirlpool |
$596.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.62
|
| Rate for Payer: Nomi Health Commercial |
$596.14
|
| Rate for Payer: PACE SWMI |
$496.78
|
| Rate for Payer: PHP Medicare Advantage |
$496.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$973.05
|
| Rate for Payer: Priority Health Medicare |
$496.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.78
|
| Rate for Payer: UHC Medicare Advantage |
$496.78
|
| Rate for Payer: UHCCP DNSP |
$496.78
|
|
|
PR INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE
|
Professional
|
Both
|
$1,570.00
|
|
|
Service Code
|
HCPCS 27303
|
| Min. Negotiated Rate |
$620.65 |
| Max. Negotiated Rate |
$1,020.50 |
| Rate for Payer: Aetna Commercial |
$831.67
|
| Rate for Payer: Aetna Medicare |
$620.65
|
| Rate for Payer: BCBS Complete |
$628.00
|
| Rate for Payer: BCBS MAPPO |
$620.65
|
| Rate for Payer: BCN Medicare Advantage |
$620.65
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cofinity Commercial |
$893.74
|
| Rate for Payer: Cofinity Commercial |
$831.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.65
|
| Rate for Payer: Healthscope Commercial |
$744.78
|
| Rate for Payer: Healthscope Whirlpool |
$744.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.68
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE SWMI |
$620.65
|
| Rate for Payer: PHP Medicare Advantage |
$620.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.50
|
| Rate for Payer: Priority Health Medicare |
$620.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.65
|
| Rate for Payer: UHC Medicare Advantage |
$620.65
|
| Rate for Payer: UHCCP DNSP |
$620.65
|
|
|
PR INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT
|
Professional
|
Both
|
$588.00
|
|
|
Service Code
|
HCPCS 62148
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$382.20 |
| Rate for Payer: Aetna Commercial |
$167.07
|
| Rate for Payer: Aetna Medicare |
$124.68
|
| Rate for Payer: BCBS Complete |
$235.20
|
| Rate for Payer: BCBS MAPPO |
$124.68
|
| Rate for Payer: BCN Medicare Advantage |
$124.68
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cofinity Commercial |
$179.54
|
| Rate for Payer: Cofinity Commercial |
$167.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.68
|
| Rate for Payer: Healthscope Commercial |
$149.62
|
| Rate for Payer: Healthscope Whirlpool |
$149.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.91
|
| Rate for Payer: Nomi Health Commercial |
$149.62
|
| Rate for Payer: PACE SWMI |
$124.68
|
| Rate for Payer: PHP Medicare Advantage |
$124.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.20
|
| Rate for Payer: Priority Health Medicare |
$124.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.68
|
| Rate for Payer: UHC Medicare Advantage |
$124.68
|
| Rate for Payer: UHCCP DNSP |
$124.68
|
|
|
PR INCIS HEART SAC TUBE
|
Professional
|
Both
|
$1,683.00
|
|
|
Service Code
|
HCPCS 33015
|
| Min. Negotiated Rate |
$673.20 |
| Max. Negotiated Rate |
$1,093.95 |
| Rate for Payer: Aetna Medicare |
$841.50
|
| Rate for Payer: BCBS Complete |
$673.20
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,093.95
|
|
|
PR INCISIONAL BIOPSY EYELID SKIN W/LID MARGIN
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 67810
|
| Min. Negotiated Rate |
$64.53 |
| Max. Negotiated Rate |
$237.25 |
| Rate for Payer: Aetna Commercial |
$86.47
|
| Rate for Payer: Aetna Medicare |
$64.53
|
| Rate for Payer: BCBS Complete |
$146.00
|
| Rate for Payer: BCBS MAPPO |
$64.53
|
| Rate for Payer: BCN Medicare Advantage |
$64.53
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$92.92
|
| Rate for Payer: Cofinity Commercial |
$86.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.53
|
| Rate for Payer: Healthscope Commercial |
$77.44
|
| Rate for Payer: Healthscope Whirlpool |
$77.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.76
|
| Rate for Payer: Nomi Health Commercial |
$77.44
|
| Rate for Payer: PACE SWMI |
$64.53
|
| Rate for Payer: PHP Medicare Advantage |
$64.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.25
|
| Rate for Payer: Priority Health Medicare |
$64.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.53
|
| Rate for Payer: UHC Medicare Advantage |
$64.53
|
| Rate for Payer: UHCCP DNSP |
$64.53
|
|
|
PR INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 11107
|
| Min. Negotiated Rate |
$28.88 |
| Max. Negotiated Rate |
$92.30 |
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna Medicare |
$28.88
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS MAPPO |
$28.88
|
| Rate for Payer: BCN Medicare Advantage |
$28.88
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$41.59
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.88
|
| Rate for Payer: Healthscope Commercial |
$34.66
|
| Rate for Payer: Healthscope Whirlpool |
$34.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.32
|
| Rate for Payer: Nomi Health Commercial |
$34.66
|
| Rate for Payer: PACE SWMI |
$28.88
|
| Rate for Payer: PHP Medicare Advantage |
$28.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.30
|
| Rate for Payer: Priority Health Medicare |
$28.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.88
|
| Rate for Payer: UHC Medicare Advantage |
$28.88
|
| Rate for Payer: UHCCP DNSP |
$28.88
|
|
|
PR INCISIONAL BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 11106
|
| Min. Negotiated Rate |
$53.81 |
| Max. Negotiated Rate |
$191.75 |
| Rate for Payer: Aetna Commercial |
$72.11
|
| Rate for Payer: Aetna Medicare |
$53.81
|
| Rate for Payer: BCBS Complete |
$118.00
|
| Rate for Payer: BCBS MAPPO |
$53.81
|
| Rate for Payer: BCN Medicare Advantage |
$53.81
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$77.49
|
| Rate for Payer: Cofinity Commercial |
$72.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.81
|
| Rate for Payer: Healthscope Commercial |
$64.57
|
| Rate for Payer: Healthscope Whirlpool |
$64.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.50
|
| Rate for Payer: Nomi Health Commercial |
$64.57
|
| Rate for Payer: PACE SWMI |
$53.81
|
| Rate for Payer: PHP Medicare Advantage |
$53.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.75
|
| Rate for Payer: Priority Health Medicare |
$53.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.81
|
| Rate for Payer: UHC Medicare Advantage |
$53.81
|
| Rate for Payer: UHCCP DNSP |
$53.81
|
|
|
PR INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 44900
|
| Min. Negotiated Rate |
$554.40 |
| Max. Negotiated Rate |
$1,098.53 |
| Rate for Payer: Aetna Commercial |
$1,022.25
|
| Rate for Payer: Aetna Medicare |
$762.87
|
| Rate for Payer: BCBS Complete |
$554.40
|
| Rate for Payer: BCBS MAPPO |
$762.87
|
| Rate for Payer: BCN Medicare Advantage |
$762.87
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$1,098.53
|
| Rate for Payer: Cofinity Commercial |
$1,022.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$762.87
|
| Rate for Payer: Healthscope Commercial |
$915.44
|
| Rate for Payer: Healthscope Whirlpool |
$915.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.01
|
| Rate for Payer: Nomi Health Commercial |
$915.44
|
| Rate for Payer: PACE SWMI |
$762.87
|
| Rate for Payer: PHP Medicare Advantage |
$762.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.90
|
| Rate for Payer: Priority Health Medicare |
$762.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$762.87
|
| Rate for Payer: UHC Medicare Advantage |
$762.87
|
| Rate for Payer: UHCCP DNSP |
$762.87
|
|
|
PR INCISION BONE CORTEX FOOT
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 28005
|
| Min. Negotiated Rate |
$460.80 |
| Max. Negotiated Rate |
$786.89 |
| Rate for Payer: Aetna Commercial |
$732.24
|
| Rate for Payer: Aetna Medicare |
$546.45
|
| Rate for Payer: BCBS Complete |
$460.80
|
| Rate for Payer: BCBS MAPPO |
$546.45
|
| Rate for Payer: BCN Medicare Advantage |
$546.45
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$786.89
|
| Rate for Payer: Cofinity Commercial |
$732.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.45
|
| Rate for Payer: Healthscope Commercial |
$655.74
|
| Rate for Payer: Healthscope Whirlpool |
$655.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.77
|
| Rate for Payer: Nomi Health Commercial |
$655.74
|
| Rate for Payer: PACE SWMI |
$546.45
|
| Rate for Payer: PHP Medicare Advantage |
$546.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.80
|
| Rate for Payer: Priority Health Medicare |
$546.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$546.45
|
| Rate for Payer: UHC Medicare Advantage |
$546.45
|
| Rate for Payer: UHCCP DNSP |
$546.45
|
|
|
PR INCISION BONE CORTEX HAND/FINGER
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 26034
|
| Min. Negotiated Rate |
$380.80 |
| Max. Negotiated Rate |
$767.62 |
| Rate for Payer: Aetna Commercial |
$714.31
|
| Rate for Payer: Aetna Medicare |
$533.07
|
| Rate for Payer: BCBS Complete |
$380.80
|
| Rate for Payer: BCBS MAPPO |
$533.07
|
| Rate for Payer: BCN Medicare Advantage |
$533.07
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$767.62
|
| Rate for Payer: Cofinity Commercial |
$714.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$533.07
|
| Rate for Payer: Healthscope Commercial |
$639.68
|
| Rate for Payer: Healthscope Whirlpool |
$639.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$559.72
|
| Rate for Payer: Nomi Health Commercial |
$639.68
|
| Rate for Payer: PACE SWMI |
$533.07
|
| Rate for Payer: PHP Medicare Advantage |
$533.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health Medicare |
$533.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$533.07
|
| Rate for Payer: UHC Medicare Advantage |
$533.07
|
| Rate for Payer: UHCCP DNSP |
$533.07
|
|
|
PR INCISION BONE CORTEX PELVIS&/HIP JOINT
|
Professional
|
Both
|
$2,070.00
|
|
|
Service Code
|
HCPCS 26992
|
| Min. Negotiated Rate |
$828.00 |
| Max. Negotiated Rate |
$1,385.12 |
| Rate for Payer: Aetna Commercial |
$1,288.93
|
| Rate for Payer: Aetna Medicare |
$961.89
|
| Rate for Payer: BCBS Complete |
$828.00
|
| Rate for Payer: BCBS MAPPO |
$961.89
|
| Rate for Payer: BCN Medicare Advantage |
$961.89
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,385.12
|
| Rate for Payer: Cofinity Commercial |
$1,288.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$961.89
|
| Rate for Payer: Healthscope Commercial |
$1,154.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,154.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,009.98
|
| Rate for Payer: Nomi Health Commercial |
$1,154.27
|
| Rate for Payer: PACE SWMI |
$961.89
|
| Rate for Payer: PHP Medicare Advantage |
$961.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,345.50
|
| Rate for Payer: Priority Health Medicare |
$961.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$961.89
|
| Rate for Payer: UHC Medicare Advantage |
$961.89
|
| Rate for Payer: UHCCP DNSP |
$961.89
|
|
