|
PR INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ
|
Professional
|
Both
|
$3,056.00
|
|
|
Service Code
|
HCPCS 44615
|
| Min. Negotiated Rate |
$634.53 |
| Max. Negotiated Rate |
$2,292.00 |
| Rate for Payer: Aetna Commercial |
$1,326.31
|
| Rate for Payer: Aetna Medicare |
$989.78
|
| Rate for Payer: BCBS Complete |
$666.26
|
| Rate for Payer: BCBS MAPPO |
$989.78
|
| Rate for Payer: BCN Commercial |
$1,605.49
|
| Rate for Payer: BCN Medicare Advantage |
$989.78
|
| Rate for Payer: Cash Price |
$2,444.80
|
| Rate for Payer: Cash Price |
$2,444.80
|
| Rate for Payer: Cofinity Commercial |
$1,425.28
|
| Rate for Payer: Cofinity Commercial |
$1,326.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$989.78
|
| Rate for Payer: Healthscope Commercial |
$1,187.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,187.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,039.27
|
| Rate for Payer: Meridian Medicaid |
$666.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,088.76
|
| Rate for Payer: Nomi Health Commercial |
$1,187.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.00
|
| Rate for Payer: PACE SWMI |
$989.78
|
| Rate for Payer: PHP Medicare Advantage |
$989.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,956.18
|
| Rate for Payer: Priority Health Medicare |
$989.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,956.18
|
| Rate for Payer: Railroad Medicare Medicare |
$989.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,920.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$989.78
|
| Rate for Payer: UHC Exchange |
$1,920.51
|
| Rate for Payer: UHC Medicaid |
$634.53
|
| Rate for Payer: UHCCP DNSP |
$989.78
|
| Rate for Payer: UHCCP Medicaid |
$634.53
|
|
|
PR INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 31500
|
| Min. Negotiated Rate |
$84.77 |
| Max. Negotiated Rate |
$281.25 |
| Rate for Payer: Aetna Commercial |
$178.69
|
| Rate for Payer: Aetna Medicare |
$133.35
|
| Rate for Payer: BCBS Complete |
$89.01
|
| Rate for Payer: BCBS MAPPO |
$133.35
|
| Rate for Payer: BCN Commercial |
$210.65
|
| Rate for Payer: BCN Medicare Advantage |
$133.35
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$192.02
|
| Rate for Payer: Cofinity Commercial |
$178.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.35
|
| Rate for Payer: Healthscope Commercial |
$160.02
|
| Rate for Payer: Healthscope Whirlpool |
$160.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.02
|
| Rate for Payer: Meridian Medicaid |
$89.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.69
|
| Rate for Payer: Nomi Health Commercial |
$160.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.25
|
| Rate for Payer: PACE SWMI |
$133.35
|
| Rate for Payer: PHP Medicare Advantage |
$133.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$198.37
|
| Rate for Payer: Priority Health Medicare |
$133.35
|
| Rate for Payer: Priority Health Narrow Network |
$198.37
|
| Rate for Payer: Railroad Medicare Medicare |
$133.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.35
|
| Rate for Payer: UHC Exchange |
$256.16
|
| Rate for Payer: UHC Medicaid |
$84.77
|
| Rate for Payer: UHCCP DNSP |
$133.35
|
| Rate for Payer: UHCCP Medicaid |
$84.77
|
|
|
PR IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 95940
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$53.18 |
| Rate for Payer: Aetna Commercial |
$35.32
|
| Rate for Payer: Aetna Medicare |
$26.36
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$26.36
|
| Rate for Payer: BCN Commercial |
$47.81
|
| Rate for Payer: BCN Medicare Advantage |
$26.36
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$35.32
|
| Rate for Payer: Cofinity Commercial |
$37.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.36
|
| Rate for Payer: Healthscope Commercial |
$31.63
|
| Rate for Payer: Healthscope Whirlpool |
$31.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.68
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.00
|
| Rate for Payer: Nomi Health Commercial |
$31.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.50
|
| Rate for Payer: PACE SWMI |
$26.36
|
| Rate for Payer: PHP Medicare Advantage |
$26.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$44.08
|
| Rate for Payer: Priority Health Medicare |
$26.36
|
| Rate for Payer: Priority Health Narrow Network |
$44.08
|
| Rate for Payer: Railroad Medicare Medicare |
$26.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.36
|
| Rate for Payer: UHC Exchange |
$53.18
|
| Rate for Payer: UHC Medicaid |
$17.04
|
| Rate for Payer: UHCCP DNSP |
$26.36
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
|
|
PR IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 95941
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$299.74 |
| Rate for Payer: Aetna Commercial |
$299.74
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: BCN Commercial |
$105.89
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 99255
|
| Min. Negotiated Rate |
$117.79 |
| Max. Negotiated Rate |
$288.90 |
| Rate for Payer: Aetna Commercial |
$208.05
|
| Rate for Payer: BCBS Complete |
$123.68
|
| Rate for Payer: BCN Commercial |
$274.89
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Meridian Medicaid |
$123.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$247.25
|
| Rate for Payer: Priority Health Narrow Network |
$247.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$288.90
|
| Rate for Payer: UHC Exchange |
$288.90
|
| Rate for Payer: UHC Medicaid |
$117.79
|
| Rate for Payer: UHCCP Medicaid |
$117.79
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 99253
|
| Min. Negotiated Rate |
$63.05 |
| Max. Negotiated Rate |
$164.93 |
| Rate for Payer: Aetna Commercial |
$119.14
|
| Rate for Payer: BCBS Complete |
$66.20
|
| Rate for Payer: BCN Commercial |
$147.90
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Meridian Medicaid |
$66.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$133.04
|
| Rate for Payer: Priority Health Narrow Network |
$133.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$164.93
|
| Rate for Payer: UHC Exchange |
$164.93
|
| Rate for Payer: UHC Medicaid |
$63.05
|
| Rate for Payer: UHCCP Medicaid |
$63.05
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 99254
|
| Min. Negotiated Rate |
$87.76 |
| Max. Negotiated Rate |
$240.11 |
| Rate for Payer: Aetna Commercial |
$172.55
|
| Rate for Payer: BCBS Complete |
$92.15
|
| Rate for Payer: BCN Commercial |
$204.67
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Meridian Medicaid |
$92.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$184.10
|
| Rate for Payer: Priority Health Narrow Network |
$184.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$240.11
|
| Rate for Payer: UHC Exchange |
$240.11
|
| Rate for Payer: UHC Medicaid |
$87.76
|
| Rate for Payer: UHCCP Medicaid |
$87.76
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 99252
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$129.75 |
| Rate for Payer: Aetna Commercial |
$77.71
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCN Commercial |
$104.58
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$94.07
|
| Rate for Payer: Priority Health Narrow Network |
$94.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.88
|
| Rate for Payer: UHC Exchange |
$106.88
|
| Rate for Payer: UHC Medicaid |
$44.73
|
| Rate for Payer: UHCCP Medicaid |
$44.73
|
|
|
PR IPRATROPIUM BROMIDE NON-COMP
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS J7644
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Aetna Commercial |
$0.59
|
| Rate for Payer: Aetna Medicare |
$0.44
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.09
|
| Rate for Payer: BCN Medicare Advantage |
$0.44
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$0.59
|
| Rate for Payer: Cofinity Commercial |
$0.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.44
|
| Rate for Payer: Healthscope Commercial |
$0.53
|
| Rate for Payer: Healthscope Whirlpool |
$0.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.48
|
| Rate for Payer: Nomi Health Commercial |
$0.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.00
|
| Rate for Payer: PACE SWMI |
$0.44
|
| Rate for Payer: PHP Medicare Advantage |
$0.44
|
| Rate for Payer: Priority Health Medicare |
$0.44
|
| Rate for Payer: Railroad Medicare Medicare |
$0.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.44
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHCCP DNSP |
$0.44
|
|
|
PR IR DEEP HEAT PAIN RELIEF 15MIN
|
Professional
|
Both
|
$53.00
|
|
|
Hospital Revenue Code
|
990
|
| 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 IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 96523
|
| Min. Negotiated Rate |
$23.97 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Aetna Commercial |
$32.12
|
| Rate for Payer: Aetna Medicare |
$23.97
|
| Rate for Payer: BCBS MAPPO |
$23.97
|
| Rate for Payer: BCN Commercial |
$35.86
|
| Rate for Payer: BCN Medicare Advantage |
$23.97
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$34.52
|
| Rate for Payer: Cofinity Commercial |
$32.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.97
|
| Rate for Payer: Healthscope Commercial |
$28.76
|
| Rate for Payer: Healthscope Whirlpool |
$28.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.37
|
| Rate for Payer: Nomi Health Commercial |
$28.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: PACE SWMI |
$23.97
|
| Rate for Payer: PHP Medicare Advantage |
$23.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$33.07
|
| Rate for Payer: Priority Health Medicare |
$23.97
|
| Rate for Payer: Priority Health Narrow Network |
$33.07
|
| Rate for Payer: Railroad Medicare Medicare |
$23.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.97
|
| Rate for Payer: UHC Exchange |
$25.94
|
| Rate for Payer: UHCCP DNSP |
$23.97
|
|
|
PR IRRIGATION CORPORA CAVERNOSA PRIAPISM
|
Professional
|
Both
|
$461.00
|
|
|
Service Code
|
HCPCS 54220
|
| Min. Negotiated Rate |
$82.64 |
| Max. Negotiated Rate |
$345.75 |
| Rate for Payer: Aetna Commercial |
$171.90
|
| Rate for Payer: Aetna Medicare |
$128.28
|
| Rate for Payer: BCBS Complete |
$86.77
|
| Rate for Payer: BCBS MAPPO |
$128.28
|
| Rate for Payer: BCN Commercial |
$200.69
|
| Rate for Payer: BCN Medicare Advantage |
$128.28
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cofinity Commercial |
$184.72
|
| Rate for Payer: Cofinity Commercial |
$171.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.28
|
| Rate for Payer: Healthscope Commercial |
$153.94
|
| Rate for Payer: Healthscope Whirlpool |
$153.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.69
|
| Rate for Payer: Meridian Medicaid |
$86.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.11
|
| Rate for Payer: Nomi Health Commercial |
$153.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.75
|
| Rate for Payer: PACE SWMI |
$128.28
|
| Rate for Payer: PHP Medicare Advantage |
$128.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$218.62
|
| Rate for Payer: Priority Health Medicare |
$128.28
|
| Rate for Payer: Priority Health Narrow Network |
$218.62
|
| Rate for Payer: Railroad Medicare Medicare |
$128.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.28
|
| Rate for Payer: UHC Exchange |
$236.55
|
| Rate for Payer: UHC Medicaid |
$82.64
|
| Rate for Payer: UHCCP DNSP |
$128.28
|
| Rate for Payer: UHCCP Medicaid |
$82.64
|
|
|
PR IRRIGATION TRAY
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS A4320
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$10.09 |
| Rate for Payer: Aetna Commercial |
$9.39
|
| Rate for Payer: Aetna Medicare |
$7.01
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$7.01
|
| Rate for Payer: BCN Commercial |
$6.71
|
| Rate for Payer: BCN Medicare Advantage |
$7.01
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$9.39
|
| Rate for Payer: Cofinity Commercial |
$10.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$8.41
|
| Rate for Payer: Healthscope Whirlpool |
$8.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.71
|
| Rate for Payer: Nomi Health Commercial |
$8.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$7.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.01
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Railroad Medicare Medicare |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.01
|
| Rate for Payer: UHC Exchange |
$2.29
|
| Rate for Payer: UHCCP DNSP |
$7.01
|
|
|
PR IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 57150
|
| Min. Negotiated Rate |
$22.36 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna Medicare |
$22.36
|
| Rate for Payer: BCBS Complete |
$49.60
|
| Rate for Payer: BCBS MAPPO |
$22.36
|
| Rate for Payer: BCN Commercial |
$37.85
|
| Rate for Payer: BCN Medicare Advantage |
$22.36
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$32.20
|
| Rate for Payer: Cofinity Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.36
|
| Rate for Payer: Healthscope Commercial |
$26.83
|
| Rate for Payer: Healthscope Whirlpool |
$26.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.60
|
| Rate for Payer: Nomi Health Commercial |
$26.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.00
|
| Rate for Payer: PACE SWMI |
$22.36
|
| Rate for Payer: PHP Medicare Advantage |
$22.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.33
|
| Rate for Payer: Priority Health Medicare |
$22.36
|
| Rate for Payer: Priority Health Narrow Network |
$38.33
|
| Rate for Payer: Railroad Medicare Medicare |
$22.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.36
|
| Rate for Payer: UHC Exchange |
$47.95
|
| Rate for Payer: UHCCP DNSP |
$22.36
|
|
|
PR IV DOP VEL&/PRESS C/FLO RSRV MEAS 1ST VESSEL
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 93571
|
| Min. Negotiated Rate |
$105.08 |
| Max. Negotiated Rate |
$461.76 |
| Rate for Payer: Aetna Commercial |
$267.31
|
| Rate for Payer: Aetna Commercial |
$267.31
|
| Rate for Payer: BCN Commercial |
$105.08
|
| Rate for Payer: BCN Commercial |
$105.08
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$154.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$285.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$285.40
|
| Rate for Payer: Priority Health Narrow Network |
$285.40
|
| Rate for Payer: Priority Health Narrow Network |
$285.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$461.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$461.76
|
| Rate for Payer: UHC Exchange |
$461.76
|
| Rate for Payer: UHC Exchange |
$461.76
|
|
|
PR IV DOP VEL&/PRESS C/FLO RSRV MEAS EA ADDL VSL
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 93572
|
| Min. Negotiated Rate |
$76.20 |
| Max. Negotiated Rate |
$221.97 |
| Rate for Payer: Aetna Commercial |
$145.84
|
| Rate for Payer: BCN Commercial |
$76.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$154.30
|
| Rate for Payer: Priority Health Narrow Network |
$154.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$221.97
|
| Rate for Payer: UHC Exchange |
$221.97
|
|
|
PR IV INFUSION HYDRATION EACH ADDITIONAL HOUR
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 96361
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$23.25 |
| Rate for Payer: Aetna Commercial |
$16.39
|
| Rate for Payer: Aetna Medicare |
$12.23
|
| Rate for Payer: BCBS MAPPO |
$12.23
|
| Rate for Payer: BCN Commercial |
$17.92
|
| Rate for Payer: BCN Medicare Advantage |
$12.23
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$16.39
|
| Rate for Payer: Cofinity Commercial |
$17.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.23
|
| Rate for Payer: Healthscope Commercial |
$14.68
|
| Rate for Payer: Healthscope Whirlpool |
$14.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.45
|
| Rate for Payer: Nomi Health Commercial |
$14.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.25
|
| Rate for Payer: PACE SWMI |
$12.23
|
| Rate for Payer: PHP Medicare Advantage |
$12.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16.53
|
| Rate for Payer: Priority Health Medicare |
$12.23
|
| Rate for Payer: Priority Health Narrow Network |
$16.53
|
| Rate for Payer: Railroad Medicare Medicare |
$12.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.23
|
| Rate for Payer: UHC Exchange |
$20.69
|
| Rate for Payer: UHCCP DNSP |
$12.23
|
|
|
PR IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 96360
|
| Min. Negotiated Rate |
$31.06 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: Aetna Medicare |
$31.06
|
| Rate for Payer: BCBS MAPPO |
$31.06
|
| Rate for Payer: BCN Commercial |
$46.31
|
| Rate for Payer: BCN Medicare Advantage |
$31.06
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.06
|
| Rate for Payer: Healthscope Commercial |
$37.27
|
| Rate for Payer: Healthscope Whirlpool |
$37.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.17
|
| Rate for Payer: Nomi Health Commercial |
$37.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.00
|
| Rate for Payer: PACE SWMI |
$31.06
|
| Rate for Payer: PHP Medicare Advantage |
$31.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$42.71
|
| Rate for Payer: Priority Health Medicare |
$31.06
|
| Rate for Payer: Priority Health Narrow Network |
$42.71
|
| Rate for Payer: Railroad Medicare Medicare |
$31.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.06
|
| Rate for Payer: UHC Exchange |
$51.97
|
| Rate for Payer: UHCCP DNSP |
$31.06
|
|
|
PR IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 96365
|
| Min. Negotiated Rate |
$62.19 |
| Max. Negotiated Rate |
$107.61 |
| Rate for Payer: Aetna Commercial |
$83.33
|
| Rate for Payer: Aetna Medicare |
$62.19
|
| Rate for Payer: BCBS MAPPO |
$62.19
|
| Rate for Payer: BCN Commercial |
$89.14
|
| Rate for Payer: BCN Medicare Advantage |
$62.19
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Cofinity Commercial |
$89.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.19
|
| Rate for Payer: Healthscope Commercial |
$74.63
|
| Rate for Payer: Healthscope Whirlpool |
$74.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.41
|
| Rate for Payer: Nomi Health Commercial |
$74.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
| Rate for Payer: PACE SWMI |
$62.19
|
| Rate for Payer: PHP Medicare Advantage |
$62.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$82.20
|
| Rate for Payer: Priority Health Medicare |
$62.19
|
| Rate for Payer: Priority Health Narrow Network |
$82.20
|
| Rate for Payer: Railroad Medicare Medicare |
$62.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.19
|
| Rate for Payer: UHC Exchange |
$107.61
|
| Rate for Payer: UHCCP DNSP |
$62.19
|
|
|
PR IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 96366
|
| Min. Negotiated Rate |
$20.11 |
| Max. Negotiated Rate |
$33.38 |
| Rate for Payer: Aetna Commercial |
$26.95
|
| Rate for Payer: Aetna Medicare |
$20.11
|
| Rate for Payer: BCBS MAPPO |
$20.11
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: BCN Medicare Advantage |
$20.11
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$26.95
|
| Rate for Payer: Cofinity Commercial |
$28.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.11
|
| Rate for Payer: Healthscope Commercial |
$24.13
|
| Rate for Payer: Healthscope Whirlpool |
$24.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.12
|
| Rate for Payer: Nomi Health Commercial |
$24.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PACE SWMI |
$20.11
|
| Rate for Payer: PHP Medicare Advantage |
$20.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.56
|
| Rate for Payer: Priority Health Medicare |
$20.11
|
| Rate for Payer: Priority Health Narrow Network |
$27.56
|
| Rate for Payer: Railroad Medicare Medicare |
$20.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.11
|
| Rate for Payer: UHC Exchange |
$33.38
|
| Rate for Payer: UHCCP DNSP |
$20.11
|
|
|
PR IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 96367
|
| Min. Negotiated Rate |
$27.76 |
| Max. Negotiated Rate |
$47.29 |
| Rate for Payer: Aetna Commercial |
$37.20
|
| Rate for Payer: Aetna Medicare |
$27.76
|
| Rate for Payer: BCBS MAPPO |
$27.76
|
| Rate for Payer: BCN Commercial |
$40.83
|
| Rate for Payer: BCN Medicare Advantage |
$27.76
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$37.20
|
| Rate for Payer: Cofinity Commercial |
$39.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.76
|
| Rate for Payer: Healthscope Commercial |
$33.31
|
| Rate for Payer: Healthscope Whirlpool |
$33.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.54
|
| Rate for Payer: Nomi Health Commercial |
$33.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.00
|
| Rate for Payer: PACE SWMI |
$27.76
|
| Rate for Payer: PHP Medicare Advantage |
$27.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37.65
|
| Rate for Payer: Priority Health Medicare |
$27.76
|
| Rate for Payer: Priority Health Narrow Network |
$37.65
|
| Rate for Payer: Railroad Medicare Medicare |
$27.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.76
|
| Rate for Payer: UHC Exchange |
$47.29
|
| Rate for Payer: UHCCP DNSP |
$27.76
|
|
|
PR IV INJECTION AGENT TEST VASCULAR FLOW FLAP/GRAFT
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 15860
|
| Min. Negotiated Rate |
$59.43 |
| Max. Negotiated Rate |
$192.10 |
| Rate for Payer: Aetna Commercial |
$124.98
|
| Rate for Payer: Aetna Medicare |
$93.27
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS MAPPO |
$93.27
|
| Rate for Payer: BCN Commercial |
$158.86
|
| Rate for Payer: BCN Medicare Advantage |
$93.27
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$134.31
|
| Rate for Payer: Cofinity Commercial |
$124.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.27
|
| Rate for Payer: Healthscope Commercial |
$111.92
|
| Rate for Payer: Healthscope Whirlpool |
$111.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.93
|
| Rate for Payer: Meridian Medicaid |
$62.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.60
|
| Rate for Payer: Nomi Health Commercial |
$111.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.75
|
| Rate for Payer: PACE SWMI |
$93.27
|
| Rate for Payer: PHP Medicare Advantage |
$93.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$145.40
|
| Rate for Payer: Priority Health Medicare |
$93.27
|
| Rate for Payer: Priority Health Narrow Network |
$145.40
|
| Rate for Payer: Railroad Medicare Medicare |
$93.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.27
|
| Rate for Payer: UHC Exchange |
$192.10
|
| Rate for Payer: UHC Medicaid |
$59.43
|
| Rate for Payer: UHCCP DNSP |
$93.27
|
| Rate for Payer: UHCCP Medicaid |
$59.43
|
|
|
PR IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 96368
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$32.25 |
| Rate for Payer: Aetna Commercial |
$26.09
|
| Rate for Payer: Aetna Medicare |
$19.47
|
| Rate for Payer: BCBS MAPPO |
$19.47
|
| Rate for Payer: BCN Commercial |
$28.39
|
| Rate for Payer: BCN Medicare Advantage |
$19.47
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$26.09
|
| Rate for Payer: Cofinity Commercial |
$28.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.47
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Healthscope Whirlpool |
$23.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.42
|
| Rate for Payer: Nomi Health Commercial |
$23.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.75
|
| Rate for Payer: PACE SWMI |
$19.47
|
| Rate for Payer: PHP Medicare Advantage |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$26.18
|
| Rate for Payer: Priority Health Medicare |
$19.47
|
| Rate for Payer: Priority Health Narrow Network |
$26.18
|
| Rate for Payer: Railroad Medicare Medicare |
$19.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.47
|
| Rate for Payer: UHC Exchange |
$32.25
|
| Rate for Payer: UHCCP DNSP |
$19.47
|
|
|
PR IV ULTRASOUND,FIRST VESSEL
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 37250
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: BCBS Complete |
$126.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
|
|
PR KETOROLAC TROMETHAMINE INJ
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1885
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$0.46
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: BCBS MAPPO |
$0.34
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Medicare Advantage |
$0.34
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$0.49
|
| Rate for Payer: Cofinity Commercial |
$0.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.34
|
| Rate for Payer: Healthscope Commercial |
$0.41
|
| Rate for Payer: Healthscope Whirlpool |
$0.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.37
|
| Rate for Payer: Nomi Health Commercial |
$0.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$0.34
|
| Rate for Payer: PHP Medicare Advantage |
$0.34
|
| Rate for Payer: Priority Health Medicare |
$0.34
|
| Rate for Payer: Railroad Medicare Medicare |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.34
|
| Rate for Payer: UHC Exchange |
$0.33
|
| Rate for Payer: UHCCP DNSP |
$0.34
|
|
