|
PR THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 97530
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$3,205.12 |
| Rate for Payer: Aetna Commercial |
$47.77
|
| Rate for Payer: Aetna Medicare |
$35.65
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$35.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,205.12
|
| Rate for Payer: BCN Commercial |
$36.21
|
| Rate for Payer: BCN Medicare Advantage |
$35.65
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$51.34
|
| Rate for Payer: Cofinity Commercial |
$47.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.65
|
| Rate for Payer: Healthscope Commercial |
$42.78
|
| Rate for Payer: Healthscope Whirlpool |
$42.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.43
|
| Rate for Payer: PACE SWMI |
$35.65
|
| Rate for Payer: PHP Medicare Advantage |
$35.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.00
|
| Rate for Payer: Priority Health Medicare |
$35.65
|
| Rate for Payer: Priority Health Narrow Network |
$75.00
|
| Rate for Payer: UHC Medicare Advantage |
$36.72
|
|
|
PR THERAPEUTIC APHERESIS PLASMA PHERESIS
|
Professional
|
Both
|
$852.00
|
|
|
Service Code
|
HCPCS 36514
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$1,024.37 |
| Rate for Payer: Aetna Commercial |
$121.71
|
| Rate for Payer: Aetna Medicare |
$90.83
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$90.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,024.37
|
| Rate for Payer: BCN Commercial |
$823.91
|
| Rate for Payer: BCN Medicare Advantage |
$90.83
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cofinity Commercial |
$130.80
|
| Rate for Payer: Cofinity Commercial |
$121.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.83
|
| Rate for Payer: Healthscope Commercial |
$109.00
|
| Rate for Payer: Healthscope Whirlpool |
$109.00
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.37
|
| Rate for Payer: PACE SWMI |
$90.83
|
| Rate for Payer: PHP Medicare Advantage |
$90.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.75
|
| Rate for Payer: Priority Health Medicare |
$90.83
|
| Rate for Payer: Priority Health Narrow Network |
$145.75
|
| Rate for Payer: UHC Medicare Advantage |
$93.55
|
|
|
PR THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 97150
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$831.02 |
| Rate for Payer: Aetna Commercial |
$23.17
|
| Rate for Payer: Aetna Medicare |
$17.29
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$17.29
|
| Rate for Payer: BCBS Trust/PPO |
$831.02
|
| Rate for Payer: BCN Commercial |
$17.29
|
| Rate for Payer: BCN Medicare Advantage |
$17.29
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$24.90
|
| Rate for Payer: Cofinity Commercial |
$23.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.29
|
| Rate for Payer: Healthscope Commercial |
$20.75
|
| Rate for Payer: Healthscope Whirlpool |
$20.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.15
|
| Rate for Payer: PACE SWMI |
$17.29
|
| Rate for Payer: PHP Medicare Advantage |
$17.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.00
|
| Rate for Payer: Priority Health Medicare |
$17.29
|
| Rate for Payer: Priority Health Narrow Network |
$75.00
|
| Rate for Payer: UHC Medicare Advantage |
$17.81
|
|
|
PR THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 96372
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$1,275.84 |
| Rate for Payer: Aetna Commercial |
$18.13
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.84
|
| Rate for Payer: BCN Commercial |
$13.70
|
| Rate for Payer: BCN Medicare Advantage |
$13.53
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$19.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.53
|
| Rate for Payer: Healthscope Commercial |
$16.24
|
| Rate for Payer: Healthscope Whirlpool |
$16.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.21
|
| Rate for Payer: PACE SWMI |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$13.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.86
|
| Rate for Payer: Priority Health Medicare |
$13.53
|
| Rate for Payer: Priority Health Narrow Network |
$18.86
|
| Rate for Payer: UHC Medicare Advantage |
$13.94
|
|
|
PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 97110
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$1,141.13 |
| Rate for Payer: Aetna Commercial |
$38.30
|
| Rate for Payer: Aetna Medicare |
$28.58
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS MAPPO |
$28.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,141.13
|
| Rate for Payer: BCN Commercial |
$28.71
|
| Rate for Payer: BCN Medicare Advantage |
$28.58
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Cofinity Commercial |
$38.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.58
|
| Rate for Payer: Healthscope Commercial |
$34.30
|
| Rate for Payer: Healthscope Whirlpool |
$34.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.01
|
| Rate for Payer: PACE SWMI |
$28.58
|
| Rate for Payer: PHP Medicare Advantage |
$28.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.00
|
| Rate for Payer: Priority Health Medicare |
$28.58
|
| Rate for Payer: Priority Health Narrow Network |
$75.00
|
| Rate for Payer: UHC Medicare Advantage |
$29.44
|
|
|
PR THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 62329
|
| Min. Negotiated Rate |
$65.82 |
| Max. Negotiated Rate |
$1,621.88 |
| Rate for Payer: Aetna Commercial |
$143.84
|
| Rate for Payer: Aetna Medicare |
$107.34
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS MAPPO |
$107.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,621.88
|
| Rate for Payer: BCN Commercial |
$419.77
|
| Rate for Payer: BCN Medicare Advantage |
$107.34
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$154.57
|
| Rate for Payer: Cofinity Commercial |
$143.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.34
|
| Rate for Payer: Healthscope Commercial |
$128.81
|
| Rate for Payer: Healthscope Whirlpool |
$128.81
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.71
|
| Rate for Payer: PACE SWMI |
$107.34
|
| Rate for Payer: PHP Medicare Advantage |
$107.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.76
|
| Rate for Payer: Priority Health Medicare |
$107.34
|
| Rate for Payer: Priority Health Narrow Network |
$181.76
|
| Rate for Payer: UHC Medicare Advantage |
$110.56
|
|
|
PR THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS 62272
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$996.90 |
| Rate for Payer: Aetna Commercial |
$121.30
|
| Rate for Payer: Aetna Medicare |
$90.52
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$90.52
|
| Rate for Payer: BCBS Trust/PPO |
$996.90
|
| Rate for Payer: BCN Commercial |
$261.44
|
| Rate for Payer: BCN Medicare Advantage |
$90.52
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cofinity Commercial |
$121.30
|
| Rate for Payer: Cofinity Commercial |
$130.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.52
|
| Rate for Payer: Healthscope Commercial |
$108.62
|
| Rate for Payer: Healthscope Whirlpool |
$108.62
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.05
|
| Rate for Payer: PACE SWMI |
$90.52
|
| Rate for Payer: PHP Medicare Advantage |
$90.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$323.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.89
|
| Rate for Payer: Priority Health Medicare |
$90.52
|
| Rate for Payer: Priority Health Narrow Network |
$152.89
|
| Rate for Payer: UHC Medicare Advantage |
$93.24
|
|
|
PR THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 96374
|
| Min. Negotiated Rate |
$34.92 |
| Max. Negotiated Rate |
$1,546.86 |
| Rate for Payer: Aetna Commercial |
$46.79
|
| Rate for Payer: Aetna Medicare |
$34.92
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCBS MAPPO |
$34.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,546.86
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Medicare Advantage |
$34.92
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$50.28
|
| Rate for Payer: Cofinity Commercial |
$46.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.92
|
| Rate for Payer: Healthscope Commercial |
$41.90
|
| Rate for Payer: Healthscope Whirlpool |
$41.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.67
|
| Rate for Payer: PACE SWMI |
$34.92
|
| Rate for Payer: PHP Medicare Advantage |
$34.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.85
|
| Rate for Payer: Priority Health Medicare |
$34.92
|
| Rate for Payer: Priority Health Narrow Network |
$49.85
|
| Rate for Payer: UHC Medicare Advantage |
$35.97
|
|
|
PR THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 97112
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$1,233.58 |
| Rate for Payer: Aetna Commercial |
$43.87
|
| Rate for Payer: Aetna Medicare |
$32.74
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$32.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,233.58
|
| Rate for Payer: BCN Commercial |
$32.95
|
| Rate for Payer: BCN Medicare Advantage |
$32.74
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$47.15
|
| Rate for Payer: Cofinity Commercial |
$43.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.74
|
| Rate for Payer: Healthscope Commercial |
$39.29
|
| Rate for Payer: Healthscope Whirlpool |
$39.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.38
|
| Rate for Payer: PACE SWMI |
$32.74
|
| Rate for Payer: PHP Medicare Advantage |
$32.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.00
|
| Rate for Payer: Priority Health Medicare |
$32.74
|
| Rate for Payer: Priority Health Narrow Network |
$75.00
|
| Rate for Payer: UHC Medicare Advantage |
$33.72
|
|
|
PR THER PX 1/> AREAS EACH 15 MINUTES MASSAGE
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 97124
|
| Min. Negotiated Rate |
$14.23 |
| Max. Negotiated Rate |
$1,345.58 |
| Rate for Payer: Aetna Commercial |
$38.73
|
| Rate for Payer: Aetna Medicare |
$28.90
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$28.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,345.58
|
| Rate for Payer: BCN Commercial |
$14.23
|
| Rate for Payer: BCN Medicare Advantage |
$28.90
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$38.73
|
| Rate for Payer: Cofinity Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.90
|
| Rate for Payer: Healthscope Commercial |
$34.68
|
| Rate for Payer: Healthscope Whirlpool |
$34.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.34
|
| Rate for Payer: PACE SWMI |
$28.90
|
| Rate for Payer: PHP Medicare Advantage |
$28.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.00
|
| Rate for Payer: Priority Health Medicare |
$28.90
|
| Rate for Payer: Priority Health Narrow Network |
$75.00
|
| Rate for Payer: UHC Medicare Advantage |
$29.77
|
|
|
PR THIGHPLASTY
|
Professional
|
Both
|
$4,500.00
|
|
|
Service Code
|
HCPCS 00538
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: BCBS Complete |
$1,800.00
|
| Rate for Payer: Cash Price |
$3,600.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,150.00
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING
|
Professional
|
Both
|
$519.00
|
|
|
Service Code
|
HCPCS 32555
|
| Min. Negotiated Rate |
$68.16 |
| Max. Negotiated Rate |
$826.79 |
| Rate for Payer: Aetna Commercial |
$143.46
|
| Rate for Payer: Aetna Medicare |
$107.06
|
| Rate for Payer: BCBS Complete |
$71.57
|
| Rate for Payer: BCBS MAPPO |
$107.06
|
| Rate for Payer: BCBS Trust/PPO |
$826.79
|
| Rate for Payer: BCN Commercial |
$463.76
|
| Rate for Payer: BCN Medicare Advantage |
$107.06
|
| Rate for Payer: Cash Price |
$415.20
|
| Rate for Payer: Cash Price |
$415.20
|
| Rate for Payer: Cofinity Commercial |
$154.17
|
| Rate for Payer: Cofinity Commercial |
$143.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.06
|
| Rate for Payer: Healthscope Commercial |
$128.47
|
| Rate for Payer: Healthscope Whirlpool |
$128.47
|
| Rate for Payer: Meridian Medicaid |
$71.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.41
|
| Rate for Payer: PACE SWMI |
$107.06
|
| Rate for Payer: PHP Medicare Advantage |
$107.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.64
|
| Rate for Payer: Priority Health Medicare |
$107.06
|
| Rate for Payer: Priority Health Narrow Network |
$148.64
|
| Rate for Payer: UHC Medicare Advantage |
$110.27
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
32554
|
| Min. Negotiated Rate |
$521.50 |
| Max. Negotiated Rate |
$745.00 |
| Rate for Payer: Aetna Commercial |
$670.50
|
| Rate for Payer: ASR ASR |
$722.65
|
| Rate for Payer: BCBS Trust/PPO |
$577.60
|
| Rate for Payer: BCN Commercial |
$577.60
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$700.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Healthscope Commercial |
$745.00
|
| Rate for Payer: Healthscope Whirlpool |
$722.65
|
| Rate for Payer: Mclaren Commercial |
$670.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$633.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$655.60
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
32554
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$813.58 |
| Rate for Payer: Aetna Commercial |
$116.41
|
| Rate for Payer: Aetna Medicare |
$86.87
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$86.87
|
| Rate for Payer: BCBS Trust/PPO |
$813.58
|
| Rate for Payer: BCN Commercial |
$343.54
|
| Rate for Payer: BCN Medicare Advantage |
$86.87
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$125.09
|
| Rate for Payer: Cofinity Commercial |
$116.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.87
|
| Rate for Payer: Healthscope Commercial |
$104.24
|
| Rate for Payer: Healthscope Whirlpool |
$104.24
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.21
|
| Rate for Payer: PACE SWMI |
$86.87
|
| Rate for Payer: PHP Medicare Advantage |
$86.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.40
|
| Rate for Payer: Priority Health Medicare |
$86.87
|
| Rate for Payer: Priority Health Narrow Network |
$120.40
|
| Rate for Payer: UHC Medicare Advantage |
$89.48
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 32554
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$813.58 |
| Rate for Payer: Aetna Commercial |
$116.41
|
| Rate for Payer: Aetna Medicare |
$86.87
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$86.87
|
| Rate for Payer: BCBS Trust/PPO |
$813.58
|
| Rate for Payer: BCN Commercial |
$343.54
|
| Rate for Payer: BCN Medicare Advantage |
$86.87
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$125.09
|
| Rate for Payer: Cofinity Commercial |
$116.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.87
|
| Rate for Payer: Healthscope Commercial |
$104.24
|
| Rate for Payer: Healthscope Whirlpool |
$104.24
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.21
|
| Rate for Payer: PACE SWMI |
$86.87
|
| Rate for Payer: PHP Medicare Advantage |
$86.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.40
|
| Rate for Payer: Priority Health Medicare |
$86.87
|
| Rate for Payer: Priority Health Narrow Network |
$120.40
|
| Rate for Payer: UHC Medicare Advantage |
$89.48
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Facility
|
OP
|
$745.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
32554
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$745.00 |
| Rate for Payer: Aetna Commercial |
$670.50
|
| Rate for Payer: Aetna Medicare |
$558.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$698.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$698.00
|
| Rate for Payer: ASR ASR |
$722.65
|
| Rate for Payer: BCBS Complete |
$320.74
|
| Rate for Payer: BCBS MAPPO |
$558.40
|
| Rate for Payer: BCBS Trust/PPO |
$577.60
|
| Rate for Payer: BCN Commercial |
$577.60
|
| Rate for Payer: BCN Medicare Advantage |
$558.40
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$700.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.40
|
| Rate for Payer: Healthscope Commercial |
$745.00
|
| Rate for Payer: Healthscope Whirlpool |
$722.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.40
|
| Rate for Payer: Mclaren Commercial |
$670.50
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Mclaren Medicare |
$558.40
|
| Rate for Payer: Meridian Medicaid |
$320.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$633.25
|
| Rate for Payer: PACE Medicare |
$530.48
|
| Rate for Payer: PACE SWMI |
$558.40
|
| Rate for Payer: PHP Commercial |
$614.24
|
| Rate for Payer: PHP Medicaid |
$305.44
|
| Rate for Payer: PHP Medicare Advantage |
$558.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$441.26
|
| Rate for Payer: Priority Health Medicare |
$558.40
|
| Rate for Payer: Priority Health Narrow Network |
$353.01
|
| Rate for Payer: Railroad Medicare Medicare |
$558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$655.60
|
| Rate for Payer: UHC Medicare Advantage |
$575.15
|
| Rate for Payer: VA VA |
$558.40
|
|
|
PR THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL
|
Professional
|
Both
|
$2,559.00
|
|
|
Service Code
|
HCPCS 32905
|
| Min. Negotiated Rate |
$840.92 |
| Max. Negotiated Rate |
$1,919.03 |
| Rate for Payer: Aetna Commercial |
$1,760.59
|
| Rate for Payer: Aetna Medicare |
$1,313.87
|
| Rate for Payer: BCBS Complete |
$882.97
|
| Rate for Payer: BCBS MAPPO |
$1,313.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,120.52
|
| Rate for Payer: BCN Commercial |
$1,919.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,313.87
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cofinity Commercial |
$1,760.59
|
| Rate for Payer: Cofinity Commercial |
$1,891.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,313.87
|
| Rate for Payer: Healthscope Commercial |
$1,576.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,576.64
|
| Rate for Payer: Meridian Medicaid |
$882.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,379.56
|
| Rate for Payer: PACE SWMI |
$1,313.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,313.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,818.38
|
| Rate for Payer: Priority Health Medicare |
$1,313.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,818.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,353.29
|
|
|
PR THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL
|
Professional
|
Both
|
$3,168.00
|
|
|
Service Code
|
HCPCS 32906
|
| Min. Negotiated Rate |
$1,036.25 |
| Max. Negotiated Rate |
$2,366.18 |
| Rate for Payer: Aetna Commercial |
$2,174.32
|
| Rate for Payer: Aetna Medicare |
$1,622.63
|
| Rate for Payer: BCBS Complete |
$1,088.06
|
| Rate for Payer: BCBS MAPPO |
$1,622.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,074.56
|
| Rate for Payer: BCN Commercial |
$2,366.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,622.63
|
| Rate for Payer: Cash Price |
$2,534.40
|
| Rate for Payer: Cash Price |
$2,534.40
|
| Rate for Payer: Cofinity Commercial |
$2,336.59
|
| Rate for Payer: Cofinity Commercial |
$2,174.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,622.63
|
| Rate for Payer: Healthscope Commercial |
$1,947.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,947.16
|
| Rate for Payer: Meridian Medicaid |
$1,088.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,703.76
|
| Rate for Payer: PACE SWMI |
$1,622.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,622.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,036.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,217.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,242.07
|
| Rate for Payer: Priority Health Medicare |
$1,622.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,242.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,671.31
|
|
|
PR THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE
|
Professional
|
Both
|
$2,324.00
|
|
|
Service Code
|
HCPCS 32654
|
| Min. Negotiated Rate |
$571.09 |
| Max. Negotiated Rate |
$1,694.73 |
| Rate for Payer: Aetna Commercial |
$1,552.10
|
| Rate for Payer: Aetna Medicare |
$1,158.28
|
| Rate for Payer: BCBS Complete |
$783.00
|
| Rate for Payer: BCBS MAPPO |
$1,158.28
|
| Rate for Payer: BCBS Trust/PPO |
$571.09
|
| Rate for Payer: BCN Commercial |
$1,694.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,158.28
|
| Rate for Payer: Cash Price |
$1,859.20
|
| Rate for Payer: Cash Price |
$1,859.20
|
| Rate for Payer: Cofinity Commercial |
$1,667.92
|
| Rate for Payer: Cofinity Commercial |
$1,552.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,158.28
|
| Rate for Payer: Healthscope Commercial |
$1,389.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,389.94
|
| Rate for Payer: Meridian Medicaid |
$783.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,216.19
|
| Rate for Payer: PACE SWMI |
$1,158.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,158.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,626.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,605.84
|
| Rate for Payer: Priority Health Medicare |
$1,158.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,193.03
|
|
|
PR THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX
|
Professional
|
Both
|
$1,385.00
|
|
|
Service Code
|
HCPCS 32606
|
| Min. Negotiated Rate |
$289.47 |
| Max. Negotiated Rate |
$969.50 |
| Rate for Payer: Aetna Commercial |
$608.59
|
| Rate for Payer: Aetna Medicare |
$454.17
|
| Rate for Payer: BCBS Complete |
$303.94
|
| Rate for Payer: BCBS MAPPO |
$454.17
|
| Rate for Payer: BCBS Trust/PPO |
$909.20
|
| Rate for Payer: BCN Commercial |
$661.18
|
| Rate for Payer: BCN Medicare Advantage |
$454.17
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cofinity Commercial |
$608.59
|
| Rate for Payer: Cofinity Commercial |
$654.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.17
|
| Rate for Payer: Healthscope Commercial |
$545.00
|
| Rate for Payer: Healthscope Whirlpool |
$545.00
|
| Rate for Payer: Meridian Medicaid |
$303.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$476.88
|
| Rate for Payer: PACE SWMI |
$454.17
|
| Rate for Payer: PHP Medicare Advantage |
$454.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.49
|
| Rate for Payer: Priority Health Medicare |
$454.17
|
| Rate for Payer: Priority Health Narrow Network |
$626.49
|
| Rate for Payer: UHC Medicare Advantage |
$467.80
|
|
|
PR THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX
|
Professional
|
Both
|
$901.00
|
|
|
Service Code
|
HCPCS 32604
|
| Min. Negotiated Rate |
$300.54 |
| Max. Negotiated Rate |
$719.54 |
| Rate for Payer: Aetna Commercial |
$631.97
|
| Rate for Payer: Aetna Medicare |
$471.62
|
| Rate for Payer: BCBS Complete |
$315.57
|
| Rate for Payer: BCBS MAPPO |
$471.62
|
| Rate for Payer: BCBS Trust/PPO |
$719.54
|
| Rate for Payer: BCN Commercial |
$686.10
|
| Rate for Payer: BCN Medicare Advantage |
$471.62
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$679.13
|
| Rate for Payer: Cofinity Commercial |
$631.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.62
|
| Rate for Payer: Healthscope Commercial |
$565.94
|
| Rate for Payer: Healthscope Whirlpool |
$565.94
|
| Rate for Payer: Meridian Medicaid |
$315.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$495.20
|
| Rate for Payer: PACE SWMI |
$471.62
|
| Rate for Payer: PHP Medicare Advantage |
$471.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.12
|
| Rate for Payer: Priority Health Medicare |
$471.62
|
| Rate for Payer: Priority Health Narrow Network |
$650.12
|
| Rate for Payer: UHC Medicare Advantage |
$485.77
|
|
|
PR THORACOSCOPY RESEXN THYMUS UNI/BILATERAL
|
Professional
|
Both
|
$4,736.00
|
|
|
Service Code
|
HCPCS 32673
|
| Min. Negotiated Rate |
$765.52 |
| Max. Negotiated Rate |
$3,315.20 |
| Rate for Payer: Aetna Commercial |
$1,602.26
|
| Rate for Payer: Aetna Medicare |
$1,195.72
|
| Rate for Payer: BCBS Complete |
$803.80
|
| Rate for Payer: BCBS MAPPO |
$1,195.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,478.18
|
| Rate for Payer: BCN Commercial |
$1,747.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,195.72
|
| Rate for Payer: Cash Price |
$3,788.80
|
| Rate for Payer: Cash Price |
$3,788.80
|
| Rate for Payer: Cofinity Commercial |
$1,602.26
|
| Rate for Payer: Cofinity Commercial |
$1,721.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,195.72
|
| Rate for Payer: Healthscope Commercial |
$1,434.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,434.86
|
| Rate for Payer: Meridian Medicaid |
$803.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,255.51
|
| Rate for Payer: PACE SWMI |
$1,195.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,195.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,315.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,655.39
|
| Rate for Payer: Priority Health Medicare |
$1,195.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,655.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,231.59
|
|
|
PR THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT
|
Professional
|
Both
|
$2,942.00
|
|
|
Service Code
|
HCPCS 32653
|
| Min. Negotiated Rate |
$561.58 |
| Max. Negotiated Rate |
$2,059.40 |
| Rate for Payer: Aetna Commercial |
$1,395.22
|
| Rate for Payer: Aetna Medicare |
$1,041.21
|
| Rate for Payer: BCBS Complete |
$700.92
|
| Rate for Payer: BCBS MAPPO |
$1,041.21
|
| Rate for Payer: BCBS Trust/PPO |
$561.58
|
| Rate for Payer: BCN Commercial |
$1,524.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.21
|
| Rate for Payer: Cash Price |
$2,353.60
|
| Rate for Payer: Cash Price |
$2,353.60
|
| Rate for Payer: Cofinity Commercial |
$1,499.34
|
| Rate for Payer: Cofinity Commercial |
$1,395.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.21
|
| Rate for Payer: Healthscope Commercial |
$1,249.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,249.45
|
| Rate for Payer: Meridian Medicaid |
$700.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,093.27
|
| Rate for Payer: PACE SWMI |
$1,041.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,059.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,444.23
|
| Rate for Payer: Priority Health Medicare |
$1,041.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,444.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.45
|
|
|
PR THORACOSCOPY W/BILOBECTOMY
|
Professional
|
Both
|
$6,329.00
|
|
|
Service Code
|
HCPCS 32670
|
| Min. Negotiated Rate |
$969.96 |
| Max. Negotiated Rate |
$4,430.30 |
| Rate for Payer: Aetna Commercial |
$2,117.03
|
| Rate for Payer: Aetna Medicare |
$1,579.87
|
| Rate for Payer: BCBS Complete |
$1,055.85
|
| Rate for Payer: BCBS MAPPO |
$1,579.87
|
| Rate for Payer: BCBS Trust/PPO |
$969.96
|
| Rate for Payer: BCN Commercial |
$2,304.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,579.87
|
| Rate for Payer: Cash Price |
$5,063.20
|
| Rate for Payer: Cash Price |
$5,063.20
|
| Rate for Payer: Cofinity Commercial |
$2,117.03
|
| Rate for Payer: Cofinity Commercial |
$2,275.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,579.87
|
| Rate for Payer: Healthscope Commercial |
$1,895.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,895.84
|
| Rate for Payer: Meridian Medicaid |
$1,055.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,658.86
|
| Rate for Payer: PACE SWMI |
$1,579.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,579.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,005.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,430.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,183.72
|
| Rate for Payer: Priority Health Medicare |
$1,579.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,183.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,627.27
|
|
|
PR THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL
|
Professional
|
Both
|
$1,223.00
|
|
|
Service Code
|
HCPCS 32607
|
| Min. Negotiated Rate |
$193.19 |
| Max. Negotiated Rate |
$856.10 |
| Rate for Payer: Aetna Commercial |
$405.93
|
| Rate for Payer: Aetna Medicare |
$302.93
|
| Rate for Payer: BCBS Complete |
$202.85
|
| Rate for Payer: BCBS MAPPO |
$302.93
|
| Rate for Payer: BCBS Trust/PPO |
$801.43
|
| Rate for Payer: BCN Commercial |
$441.76
|
| Rate for Payer: BCN Medicare Advantage |
$302.93
|
| Rate for Payer: Cash Price |
$978.40
|
| Rate for Payer: Cash Price |
$978.40
|
| Rate for Payer: Cofinity Commercial |
$436.22
|
| Rate for Payer: Cofinity Commercial |
$405.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.93
|
| Rate for Payer: Healthscope Commercial |
$363.52
|
| Rate for Payer: Healthscope Whirlpool |
$363.52
|
| Rate for Payer: Meridian Medicaid |
$202.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.08
|
| Rate for Payer: PACE SWMI |
$302.93
|
| Rate for Payer: PHP Medicare Advantage |
$302.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$856.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.59
|
| Rate for Payer: Priority Health Medicare |
$302.93
|
| Rate for Payer: Priority Health Narrow Network |
$418.59
|
| Rate for Payer: UHC Medicare Advantage |
$312.02
|
|
