|
PR INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA
|
Professional
|
Both
|
$974.00
|
|
|
Service Code
|
HCPCS 36010
|
| Min. Negotiated Rate |
$67.31 |
| Max. Negotiated Rate |
$1,275.84 |
| Rate for Payer: Aetna Commercial |
$147.28
|
| Rate for Payer: Aetna Medicare |
$487.00
|
| Rate for Payer: BCBS Complete |
$70.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.84
|
| Rate for Payer: BCN Commercial |
$796.06
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Meridian Medicaid |
$70.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.59
|
| Rate for Payer: Priority Health Narrow Network |
$168.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.79
|
| Rate for Payer: UHC Exchange |
$161.79
|
| Rate for Payer: UHCCP Medicaid |
$67.31
|
|
|
PR INTRODUCTION CATHETER AORTA
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 36200
|
| Min. Negotiated Rate |
$87.33 |
| Max. Negotiated Rate |
$1,527.32 |
| Rate for Payer: Aetna Commercial |
$187.30
|
| Rate for Payer: Aetna Medicare |
$288.00
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,527.32
|
| Rate for Payer: BCN Commercial |
$870.82
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.45
|
| Rate for Payer: Priority Health Narrow Network |
$216.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$207.28
|
| Rate for Payer: UHC Exchange |
$207.28
|
| Rate for Payer: UHCCP Medicaid |
$87.33
|
|
|
PR INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 44500
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$1,612.90 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: Aetna Medicare |
$69.50
|
| Rate for Payer: BCBS Complete |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.90
|
| Rate for Payer: BCN Commercial |
$27.85
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Meridian Medicaid |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.41
|
| Rate for Payer: Priority Health Narrow Network |
$33.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.06
|
| Rate for Payer: UHC Exchange |
$32.06
|
| Rate for Payer: UHCCP Medicaid |
$12.14
|
|
|
PR INTRODUCTION NEEDLE/INTRACATHETER VEIN
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 36000
|
| Min. Negotiated Rate |
$11.94 |
| Max. Negotiated Rate |
$772.37 |
| Rate for Payer: Aetna Commercial |
$11.94
|
| Rate for Payer: Aetna Medicare |
$90.00
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: BCBS Trust/PPO |
$772.37
|
| Rate for Payer: BCN Commercial |
$35.73
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.36
|
| Rate for Payer: Priority Health Narrow Network |
$14.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.40
|
| Rate for Payer: UHC Exchange |
$12.40
|
|
|
PR INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 36100
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$1,575.39 |
| Rate for Payer: Aetna Commercial |
$211.05
|
| Rate for Payer: Aetna Medicare |
$367.50
|
| Rate for Payer: BCBS Complete |
$100.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.39
|
| Rate for Payer: BCN Commercial |
$827.33
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Meridian Medicaid |
$100.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.66
|
| Rate for Payer: Priority Health Narrow Network |
$236.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.20
|
| Rate for Payer: UHC Exchange |
$214.20
|
| Rate for Payer: UHCCP Medicaid |
$95.42
|
|
|
PR INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 36140
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$1,951.54 |
| Rate for Payer: Aetna Commercial |
$120.54
|
| Rate for Payer: Aetna Medicare |
$471.00
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,951.54
|
| Rate for Payer: BCN Commercial |
$749.63
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.28
|
| Rate for Payer: Priority Health Narrow Network |
$138.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.60
|
| Rate for Payer: UHC Exchange |
$138.60
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
|
PR INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ
|
Professional
|
Both
|
$2,967.00
|
|
|
Service Code
|
HCPCS 44615
|
| Min. Negotiated Rate |
$190.72 |
| Max. Negotiated Rate |
$1,928.55 |
| Rate for Payer: Aetna Commercial |
$1,443.69
|
| Rate for Payer: Aetna Medicare |
$1,483.50
|
| Rate for Payer: BCBS Complete |
$721.05
|
| Rate for Payer: BCBS Trust/PPO |
$190.72
|
| Rate for Payer: BCN Commercial |
$1,550.58
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Meridian Medicaid |
$721.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$686.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,905.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,905.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,302.79
|
| Rate for Payer: UHC Exchange |
$1,302.79
|
| Rate for Payer: UHCCP Medicaid |
$686.71
|
|
|
PR INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 31500
|
| Min. Negotiated Rate |
$90.10 |
| Max. Negotiated Rate |
$1,530.49 |
| Rate for Payer: Aetna Commercial |
$184.93
|
| Rate for Payer: Aetna Medicare |
$182.00
|
| Rate for Payer: BCBS Complete |
$94.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,530.49
|
| Rate for Payer: BCN Commercial |
$203.78
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Meridian Medicaid |
$94.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.27
|
| Rate for Payer: Priority Health Narrow Network |
$193.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.94
|
| Rate for Payer: UHC Exchange |
$128.94
|
| Rate for Payer: UHCCP Medicaid |
$90.10
|
|
|
PR IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 95940
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$595.92 |
| Rate for Payer: Aetna Commercial |
$36.02
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS Trust/PPO |
$595.92
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.97
|
| Rate for Payer: Priority Health Narrow Network |
$42.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.04
|
| Rate for Payer: UHC Exchange |
$36.04
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
|
|
PR IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 95941
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$299.74 |
| Rate for Payer: Aetna Commercial |
$299.74
|
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS Trust/PPO |
$126.79
|
| Rate for Payer: BCN Commercial |
$104.76
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 99255
|
| Min. Negotiated Rate |
$75.02 |
| Max. Negotiated Rate |
$269.75 |
| Rate for Payer: Aetna Commercial |
$208.05
|
| Rate for Payer: Aetna Medicare |
$174.00
|
| Rate for Payer: BCBS Complete |
$123.46
|
| Rate for Payer: BCBS Trust/PPO |
$75.02
|
| Rate for Payer: BCN Commercial |
$269.75
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Meridian Medicaid |
$123.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.14
|
| Rate for Payer: Priority Health Narrow Network |
$248.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$226.34
|
| Rate for Payer: UHC Exchange |
$226.34
|
| Rate for Payer: UHCCP Medicaid |
$117.58
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 99253
|
| Min. Negotiated Rate |
$63.26 |
| Max. Negotiated Rate |
$286.87 |
| Rate for Payer: Aetna Commercial |
$119.14
|
| Rate for Payer: Aetna Medicare |
$104.50
|
| Rate for Payer: BCBS Complete |
$66.42
|
| Rate for Payer: BCBS Trust/PPO |
$286.87
|
| Rate for Payer: BCN Commercial |
$144.65
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Meridian Medicaid |
$66.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.81
|
| Rate for Payer: Priority Health Narrow Network |
$132.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.68
|
| Rate for Payer: UHC Exchange |
$129.68
|
| Rate for Payer: UHCCP Medicaid |
$63.26
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 99254
|
| Min. Negotiated Rate |
$87.54 |
| Max. Negotiated Rate |
$245.66 |
| Rate for Payer: Aetna Commercial |
$172.55
|
| Rate for Payer: Aetna Medicare |
$133.00
|
| Rate for Payer: BCBS Complete |
$91.92
|
| Rate for Payer: BCBS Trust/PPO |
$245.66
|
| Rate for Payer: BCN Commercial |
$201.34
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Meridian Medicaid |
$91.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.42
|
| Rate for Payer: Priority Health Narrow Network |
$184.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.14
|
| Rate for Payer: UHC Exchange |
$187.14
|
| Rate for Payer: UHCCP Medicaid |
$87.54
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 99252
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$176.98 |
| Rate for Payer: Aetna Commercial |
$77.71
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS Trust/PPO |
$176.98
|
| Rate for Payer: BCN Commercial |
$103.60
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.68
|
| Rate for Payer: Priority Health Narrow Network |
$94.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.09
|
| Rate for Payer: UHC Exchange |
$85.09
|
| Rate for Payer: UHCCP Medicaid |
$44.73
|
|
|
PR IPRATROPIUM BROMIDE NON-COMP
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS J7644
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$2.60 |
| Rate for Payer: Aetna Commercial |
$0.33
|
| Rate for Payer: Aetna Medicare |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCN Commercial |
$0.04
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.38
|
| Rate for Payer: UHC Exchange |
$0.38
|
|
|
PR IR DEEP HEAT PAIN RELIEF 15MIN
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 00099
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
|
PR IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 96523
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$1,469.20 |
| Rate for Payer: Aetna Commercial |
$33.19
|
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,469.20
|
| Rate for Payer: BCN Commercial |
$37.14
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.93
|
| Rate for Payer: Priority Health Narrow Network |
$33.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.26
|
| Rate for Payer: UHC Exchange |
$26.26
|
|
|
PR IRRIGATION CORPORA CAVERNOSA PRIAPISM
|
Professional
|
Both
|
$448.00
|
|
|
Service Code
|
HCPCS 54220
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$460.68 |
| Rate for Payer: Aetna Commercial |
$171.63
|
| Rate for Payer: Aetna Medicare |
$224.00
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS Trust/PPO |
$460.68
|
| Rate for Payer: BCN Commercial |
$321.55
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.11
|
| Rate for Payer: Priority Health Narrow Network |
$214.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.74
|
| Rate for Payer: UHC Exchange |
$162.74
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
|
|
PR IRRIGATION TRAY
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS A4320
|
| Min. Negotiated Rate |
$3.11 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Commercial |
$4.58
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCN Commercial |
$5.42
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.11
|
| Rate for Payer: UHC Exchange |
$3.11
|
|
|
PR IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 57150
|
| Min. Negotiated Rate |
$31.87 |
| Max. Negotiated Rate |
$2,018.63 |
| Rate for Payer: Aetna Commercial |
$31.87
|
| Rate for Payer: Aetna Medicare |
$60.00
|
| Rate for Payer: BCBS Complete |
$48.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,018.63
|
| Rate for Payer: BCN Commercial |
$85.52
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.19
|
| Rate for Payer: Priority Health Narrow Network |
$38.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.83
|
| Rate for Payer: UHC Exchange |
$33.83
|
|
|
PR IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 93571
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$640.30 |
| Rate for Payer: Aetna Commercial |
$267.31
|
| Rate for Payer: Aetna Commercial |
$267.31
|
| Rate for Payer: Aetna Medicare |
$100.00
|
| Rate for Payer: Aetna Medicare |
$178.50
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$295.16
|
| Rate for Payer: BCN Commercial |
$295.16
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.87
|
| Rate for Payer: Priority Health Narrow Network |
$98.87
|
| Rate for Payer: Priority Health Narrow Network |
$98.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.80
|
| Rate for Payer: UHC Exchange |
$348.80
|
| Rate for Payer: UHC Exchange |
$348.80
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
|
|
PR IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 93572
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$231.89 |
| Rate for Payer: Aetna Commercial |
$145.84
|
| Rate for Payer: Aetna Medicare |
$140.50
|
| Rate for Payer: BCBS Complete |
$34.22
|
| Rate for Payer: BCBS Trust/PPO |
$78.72
|
| Rate for Payer: BCN Commercial |
$165.66
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Meridian Medicaid |
$34.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.04
|
| Rate for Payer: Priority Health Narrow Network |
$72.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.89
|
| Rate for Payer: UHC Exchange |
$231.89
|
| Rate for Payer: UHCCP Medicaid |
$32.59
|
|
|
PR IV INFUSION HYDRATION EACH ADDITIONAL HOUR
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 96361
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$22.72 |
| Rate for Payer: Aetna Commercial |
$14.58
|
| Rate for Payer: Aetna Medicare |
$15.00
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$22.72
|
| Rate for Payer: BCN Commercial |
$18.57
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.74
|
| Rate for Payer: Priority Health Narrow Network |
$16.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.82
|
| Rate for Payer: UHC Exchange |
$15.82
|
|
|
PR IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR
|
Professional
|
Both
|
$109.00
|
|
|
Service Code
|
HCPCS 96360
|
| Min. Negotiated Rate |
$37.67 |
| Max. Negotiated Rate |
$190.72 |
| Rate for Payer: Aetna Commercial |
$37.67
|
| Rate for Payer: Aetna Medicare |
$54.50
|
| Rate for Payer: BCBS Complete |
$43.60
|
| Rate for Payer: BCBS Trust/PPO |
$190.72
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.88
|
| Rate for Payer: Priority Health Narrow Network |
$43.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.84
|
| Rate for Payer: UHC Exchange |
$55.84
|
|
|
PR IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 96365
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Aetna Commercial |
$75.96
|
| Rate for Payer: Aetna Medicare |
$66.00
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: BCBS Trust/PPO |
$168.00
|
| Rate for Payer: BCN Commercial |
$93.34
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.03
|
| Rate for Payer: Priority Health Narrow Network |
$85.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.57
|
| Rate for Payer: UHC Exchange |
$68.57
|
|
