|
PR NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID
|
Professional
|
Both
|
$2,173.00
|
|
|
Service Code
|
HCPCS 31290
|
| Min. Negotiated Rate |
$632.82 |
| Max. Negotiated Rate |
$1,992.72 |
| Rate for Payer: Aetna Commercial |
$1,312.14
|
| Rate for Payer: Aetna Medicare |
$979.21
|
| Rate for Payer: BCBS Complete |
$664.46
|
| Rate for Payer: BCBS MAPPO |
$979.21
|
| Rate for Payer: BCN Commercial |
$1,715.55
|
| Rate for Payer: BCN Medicare Advantage |
$979.21
|
| Rate for Payer: Cash Price |
$1,738.40
|
| Rate for Payer: Cash Price |
$1,738.40
|
| Rate for Payer: Cofinity Commercial |
$1,410.06
|
| Rate for Payer: Cofinity Commercial |
$1,312.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$979.21
|
| Rate for Payer: Healthscope Commercial |
$1,175.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,175.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.17
|
| Rate for Payer: Meridian Medicaid |
$664.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,077.13
|
| Rate for Payer: Nomi Health Commercial |
$1,175.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,629.75
|
| Rate for Payer: PACE SWMI |
$979.21
|
| Rate for Payer: PHP Medicare Advantage |
$979.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$632.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,615.54
|
| Rate for Payer: Priority Health Medicare |
$979.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,615.54
|
| Rate for Payer: Railroad Medicare Medicare |
$979.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,992.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$979.21
|
| Rate for Payer: UHC Exchange |
$1,992.72
|
| Rate for Payer: UHC Medicaid |
$632.82
|
| Rate for Payer: UHCCP DNSP |
$979.21
|
| Rate for Payer: UHCCP Medicaid |
$632.82
|
|
|
PR NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID
|
Professional
|
Both
|
$2,388.00
|
|
|
Service Code
|
HCPCS 31291
|
| Min. Negotiated Rate |
$686.71 |
| Max. Negotiated Rate |
$2,129.55 |
| Rate for Payer: Aetna Commercial |
$1,427.17
|
| Rate for Payer: Aetna Medicare |
$1,065.05
|
| Rate for Payer: BCBS Complete |
$721.05
|
| Rate for Payer: BCBS MAPPO |
$1,065.05
|
| Rate for Payer: BCN Commercial |
$1,836.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,065.05
|
| Rate for Payer: Cash Price |
$1,910.40
|
| Rate for Payer: Cash Price |
$1,910.40
|
| Rate for Payer: Cofinity Commercial |
$1,533.67
|
| Rate for Payer: Cofinity Commercial |
$1,427.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,065.05
|
| Rate for Payer: Healthscope Commercial |
$1,278.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,278.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,118.30
|
| Rate for Payer: Meridian Medicaid |
$721.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,171.56
|
| Rate for Payer: Nomi Health Commercial |
$1,278.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,791.00
|
| Rate for Payer: PACE SWMI |
$1,065.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,065.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$686.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,729.49
|
| Rate for Payer: Priority Health Medicare |
$1,065.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,729.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,065.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,129.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,065.05
|
| Rate for Payer: UHC Exchange |
$2,129.55
|
| Rate for Payer: UHC Medicaid |
$686.71
|
| Rate for Payer: UHCCP DNSP |
$1,065.05
|
| Rate for Payer: UHCCP Medicaid |
$686.71
|
|
|
PR NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN
|
Professional
|
Both
|
$2,117.00
|
|
|
Service Code
|
HCPCS 31292
|
| Min. Negotiated Rate |
$544.85 |
| Max. Negotiated Rate |
$1,729.23 |
| Rate for Payer: Aetna Commercial |
$1,127.68
|
| Rate for Payer: Aetna Medicare |
$841.55
|
| Rate for Payer: BCBS Complete |
$572.09
|
| Rate for Payer: BCBS MAPPO |
$841.55
|
| Rate for Payer: BCN Commercial |
$1,480.50
|
| Rate for Payer: BCN Medicare Advantage |
$841.55
|
| Rate for Payer: Cash Price |
$1,693.60
|
| Rate for Payer: Cash Price |
$1,693.60
|
| Rate for Payer: Cofinity Commercial |
$1,211.83
|
| Rate for Payer: Cofinity Commercial |
$1,127.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$841.55
|
| Rate for Payer: Healthscope Commercial |
$1,009.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,009.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$883.63
|
| Rate for Payer: Meridian Medicaid |
$572.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$925.71
|
| Rate for Payer: Nomi Health Commercial |
$1,009.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,587.75
|
| Rate for Payer: PACE SWMI |
$841.55
|
| Rate for Payer: PHP Medicare Advantage |
$841.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$544.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,394.19
|
| Rate for Payer: Priority Health Medicare |
$841.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,394.19
|
| Rate for Payer: Railroad Medicare Medicare |
$841.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,729.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$841.55
|
| Rate for Payer: UHC Exchange |
$1,729.23
|
| Rate for Payer: UHC Medicaid |
$544.85
|
| Rate for Payer: UHCCP DNSP |
$841.55
|
| Rate for Payer: UHCCP Medicaid |
$544.85
|
|
|
PR NASAL/SINUS NDSC SURG W/BX POLYPC/DBRDMT SPX
|
Professional
|
Both
|
$609.00
|
|
|
Service Code
|
HCPCS 31237
|
| Min. Negotiated Rate |
$88.18 |
| Max. Negotiated Rate |
$456.75 |
| Rate for Payer: Aetna Commercial |
$182.64
|
| Rate for Payer: Aetna Medicare |
$136.30
|
| Rate for Payer: BCBS Complete |
$92.59
|
| Rate for Payer: BCBS MAPPO |
$136.30
|
| Rate for Payer: BCN Commercial |
$189.67
|
| Rate for Payer: BCN Medicare Advantage |
$136.30
|
| Rate for Payer: Cash Price |
$487.20
|
| Rate for Payer: Cash Price |
$487.20
|
| Rate for Payer: Cofinity Commercial |
$196.27
|
| Rate for Payer: Cofinity Commercial |
$182.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.30
|
| Rate for Payer: Healthscope Commercial |
$163.56
|
| Rate for Payer: Healthscope Whirlpool |
$163.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.12
|
| Rate for Payer: Meridian Medicaid |
$92.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.93
|
| Rate for Payer: Nomi Health Commercial |
$163.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.75
|
| Rate for Payer: PACE SWMI |
$136.30
|
| Rate for Payer: PHP Medicare Advantage |
$136.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$226.50
|
| Rate for Payer: Priority Health Medicare |
$136.30
|
| Rate for Payer: Priority Health Narrow Network |
$226.50
|
| Rate for Payer: Railroad Medicare Medicare |
$136.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.30
|
| Rate for Payer: UHC Exchange |
$276.59
|
| Rate for Payer: UHC Medicaid |
$88.18
|
| Rate for Payer: UHCCP DNSP |
$136.30
|
| Rate for Payer: UHCCP Medicaid |
$88.18
|
|
|
PR NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION
|
Professional
|
Both
|
$533.00
|
|
|
Service Code
|
HCPCS 31240
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$399.75 |
| Rate for Payer: Aetna Commercial |
$180.59
|
| Rate for Payer: Aetna Medicare |
$134.77
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$134.77
|
| Rate for Payer: BCN Commercial |
$238.54
|
| Rate for Payer: BCN Medicare Advantage |
$134.77
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$194.07
|
| Rate for Payer: Cofinity Commercial |
$180.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.77
|
| Rate for Payer: Healthscope Commercial |
$161.72
|
| Rate for Payer: Healthscope Whirlpool |
$161.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.51
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.25
|
| Rate for Payer: Nomi Health Commercial |
$161.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
| Rate for Payer: PACE SWMI |
$134.77
|
| Rate for Payer: PHP Medicare Advantage |
$134.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$224.63
|
| Rate for Payer: Priority Health Medicare |
$134.77
|
| Rate for Payer: Priority Health Narrow Network |
$224.63
|
| Rate for Payer: Railroad Medicare Medicare |
$134.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$275.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.77
|
| Rate for Payer: UHC Exchange |
$275.49
|
| Rate for Payer: UHC Medicaid |
$87.12
|
| Rate for Payer: UHCCP DNSP |
$134.77
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
|
|
PR NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMORRHAGE
|
Professional
|
Both
|
$667.00
|
|
|
Service Code
|
HCPCS 31238
|
| Min. Negotiated Rate |
$92.02 |
| Max. Negotiated Rate |
$500.25 |
| Rate for Payer: Aetna Commercial |
$190.70
|
| Rate for Payer: Aetna Medicare |
$142.31
|
| Rate for Payer: BCBS Complete |
$96.62
|
| Rate for Payer: BCBS MAPPO |
$142.31
|
| Rate for Payer: BCN Commercial |
$250.49
|
| Rate for Payer: BCN Medicare Advantage |
$142.31
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cofinity Commercial |
$204.93
|
| Rate for Payer: Cofinity Commercial |
$190.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.31
|
| Rate for Payer: Healthscope Commercial |
$170.77
|
| Rate for Payer: Healthscope Whirlpool |
$170.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.43
|
| Rate for Payer: Meridian Medicaid |
$96.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.54
|
| Rate for Payer: Nomi Health Commercial |
$170.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.25
|
| Rate for Payer: PACE SWMI |
$142.31
|
| Rate for Payer: PHP Medicare Advantage |
$142.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$235.88
|
| Rate for Payer: Priority Health Medicare |
$142.31
|
| Rate for Payer: Priority Health Narrow Network |
$235.88
|
| Rate for Payer: Railroad Medicare Medicare |
$142.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.31
|
| Rate for Payer: UHC Exchange |
$290.70
|
| Rate for Payer: UHC Medicaid |
$92.02
|
| Rate for Payer: UHCCP DNSP |
$142.31
|
| Rate for Payer: UHCCP Medicaid |
$92.02
|
|
|
PR NASAL/SINUS NDSC SURG W/DACRYOCYSTORHINOSTOMY
|
Professional
|
Both
|
$1,372.00
|
|
|
Service Code
|
HCPCS 31239
|
| Min. Negotiated Rate |
$334.62 |
| Max. Negotiated Rate |
$1,053.40 |
| Rate for Payer: Aetna Commercial |
$685.84
|
| Rate for Payer: Aetna Medicare |
$511.82
|
| Rate for Payer: BCBS Complete |
$351.35
|
| Rate for Payer: BCBS MAPPO |
$511.82
|
| Rate for Payer: BCN Commercial |
$910.31
|
| Rate for Payer: BCN Medicare Advantage |
$511.82
|
| Rate for Payer: Cash Price |
$1,097.60
|
| Rate for Payer: Cash Price |
$1,097.60
|
| Rate for Payer: Cofinity Commercial |
$737.02
|
| Rate for Payer: Cofinity Commercial |
$685.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.82
|
| Rate for Payer: Healthscope Commercial |
$614.18
|
| Rate for Payer: Healthscope Whirlpool |
$614.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$537.41
|
| Rate for Payer: Meridian Medicaid |
$351.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$563.00
|
| Rate for Payer: Nomi Health Commercial |
$614.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.00
|
| Rate for Payer: PACE SWMI |
$511.82
|
| Rate for Payer: PHP Medicare Advantage |
$511.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$857.24
|
| Rate for Payer: Priority Health Medicare |
$511.82
|
| Rate for Payer: Priority Health Narrow Network |
$857.24
|
| Rate for Payer: Railroad Medicare Medicare |
$511.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,053.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$511.82
|
| Rate for Payer: UHC Exchange |
$1,053.40
|
| Rate for Payer: UHC Medicaid |
$334.62
|
| Rate for Payer: UHCCP DNSP |
$511.82
|
| Rate for Payer: UHCCP Medicaid |
$334.62
|
|
|
PR NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS
|
Professional
|
Both
|
$588.00
|
|
|
Service Code
|
HCPCS 31296
|
| Min. Negotiated Rate |
$97.13 |
| Max. Negotiated Rate |
$441.00 |
| Rate for Payer: Aetna Commercial |
$202.26
|
| Rate for Payer: Aetna Medicare |
$150.94
|
| Rate for Payer: BCBS Complete |
$101.99
|
| Rate for Payer: BCBS MAPPO |
$150.94
|
| Rate for Payer: BCN Commercial |
$269.41
|
| Rate for Payer: BCN Medicare Advantage |
$150.94
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cofinity Commercial |
$217.35
|
| Rate for Payer: Cofinity Commercial |
$202.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.94
|
| Rate for Payer: Healthscope Commercial |
$181.13
|
| Rate for Payer: Healthscope Whirlpool |
$181.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.49
|
| Rate for Payer: Meridian Medicaid |
$101.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$166.03
|
| Rate for Payer: Nomi Health Commercial |
$181.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$441.00
|
| Rate for Payer: PACE SWMI |
$150.94
|
| Rate for Payer: PHP Medicare Advantage |
$150.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$253.70
|
| Rate for Payer: Priority Health Medicare |
$150.94
|
| Rate for Payer: Priority Health Narrow Network |
$253.70
|
| Rate for Payer: Railroad Medicare Medicare |
$150.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$150.94
|
| Rate for Payer: UHC Exchange |
$314.73
|
| Rate for Payer: UHC Medicaid |
$97.13
|
| Rate for Payer: UHCCP DNSP |
$150.94
|
| Rate for Payer: UHCCP Medicaid |
$97.13
|
|
|
PR NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS
|
Professional
|
Both
|
$4,113.00
|
|
|
Service Code
|
HCPCS 31295
|
| Min. Negotiated Rate |
$86.05 |
| Max. Negotiated Rate |
$3,084.75 |
| Rate for Payer: Aetna Commercial |
$179.10
|
| Rate for Payer: Aetna Medicare |
$133.66
|
| Rate for Payer: BCBS Complete |
$90.35
|
| Rate for Payer: BCBS MAPPO |
$133.66
|
| Rate for Payer: BCN Commercial |
$236.04
|
| Rate for Payer: BCN Medicare Advantage |
$133.66
|
| Rate for Payer: Cash Price |
$3,290.40
|
| Rate for Payer: Cash Price |
$3,290.40
|
| Rate for Payer: Cofinity Commercial |
$192.47
|
| Rate for Payer: Cofinity Commercial |
$179.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.66
|
| Rate for Payer: Healthscope Commercial |
$160.39
|
| Rate for Payer: Healthscope Whirlpool |
$160.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.34
|
| Rate for Payer: Meridian Medicaid |
$90.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.03
|
| Rate for Payer: Nomi Health Commercial |
$160.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,084.75
|
| Rate for Payer: PACE SWMI |
$133.66
|
| Rate for Payer: PHP Medicare Advantage |
$133.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$222.28
|
| Rate for Payer: Priority Health Medicare |
$133.66
|
| Rate for Payer: Priority Health Narrow Network |
$222.28
|
| Rate for Payer: Railroad Medicare Medicare |
$133.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.66
|
| Rate for Payer: UHC Exchange |
$276.07
|
| Rate for Payer: UHC Medicaid |
$86.05
|
| Rate for Payer: UHCCP DNSP |
$133.66
|
| Rate for Payer: UHCCP Medicaid |
$86.05
|
|
|
PR NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS
|
Professional
|
Both
|
$3,370.00
|
|
|
Service Code
|
HCPCS 31297
|
| Min. Negotiated Rate |
$78.81 |
| Max. Negotiated Rate |
$2,527.50 |
| Rate for Payer: Aetna Commercial |
$163.94
|
| Rate for Payer: Aetna Medicare |
$122.34
|
| Rate for Payer: BCBS Complete |
$82.75
|
| Rate for Payer: BCBS MAPPO |
$122.34
|
| Rate for Payer: BCN Commercial |
$215.12
|
| Rate for Payer: BCN Medicare Advantage |
$122.34
|
| Rate for Payer: Cash Price |
$2,696.00
|
| Rate for Payer: Cash Price |
$2,696.00
|
| Rate for Payer: Cofinity Commercial |
$176.17
|
| Rate for Payer: Cofinity Commercial |
$163.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.34
|
| Rate for Payer: Healthscope Commercial |
$146.81
|
| Rate for Payer: Healthscope Whirlpool |
$146.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.46
|
| Rate for Payer: Meridian Medicaid |
$82.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.57
|
| Rate for Payer: Nomi Health Commercial |
$146.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,527.50
|
| Rate for Payer: PACE SWMI |
$122.34
|
| Rate for Payer: PHP Medicare Advantage |
$122.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$202.59
|
| Rate for Payer: Priority Health Medicare |
$122.34
|
| Rate for Payer: Priority Health Narrow Network |
$202.59
|
| Rate for Payer: Railroad Medicare Medicare |
$122.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.34
|
| Rate for Payer: UHC Exchange |
$251.55
|
| Rate for Payer: UHC Medicaid |
$78.81
|
| Rate for Payer: UHCCP DNSP |
$122.34
|
| Rate for Payer: UHCCP Medicaid |
$78.81
|
|
|
PR NASAL/SINUS NDSC SURG W/LIG SPHENOPALATINE ART
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 31241
|
| Min. Negotiated Rate |
$237.92 |
| Max. Negotiated Rate |
$782.20 |
| Rate for Payer: Aetna Commercial |
$497.84
|
| Rate for Payer: Aetna Medicare |
$371.52
|
| Rate for Payer: BCBS Complete |
$249.82
|
| Rate for Payer: BCBS MAPPO |
$371.52
|
| Rate for Payer: BCN Commercial |
$660.33
|
| Rate for Payer: BCN Medicare Advantage |
$371.52
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$534.99
|
| Rate for Payer: Cofinity Commercial |
$497.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.52
|
| Rate for Payer: Healthscope Commercial |
$445.82
|
| Rate for Payer: Healthscope Whirlpool |
$445.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.10
|
| Rate for Payer: Meridian Medicaid |
$249.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$408.67
|
| Rate for Payer: Nomi Health Commercial |
$445.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE SWMI |
$371.52
|
| Rate for Payer: PHP Medicare Advantage |
$371.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$621.82
|
| Rate for Payer: Priority Health Medicare |
$371.52
|
| Rate for Payer: Priority Health Narrow Network |
$621.82
|
| Rate for Payer: Railroad Medicare Medicare |
$371.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$782.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.52
|
| Rate for Payer: UHC Exchange |
$782.20
|
| Rate for Payer: UHC Medicaid |
$237.92
|
| Rate for Payer: UHCCP DNSP |
$371.52
|
| Rate for Payer: UHCCP Medicaid |
$237.92
|
|
|
PR NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN
|
Professional
|
Both
|
$2,669.00
|
|
|
Service Code
|
HCPCS 31294
|
| Min. Negotiated Rate |
$670.95 |
| Max. Negotiated Rate |
$2,143.87 |
| Rate for Payer: Aetna Commercial |
$1,392.33
|
| Rate for Payer: Aetna Medicare |
$1,039.05
|
| Rate for Payer: BCBS Complete |
$704.50
|
| Rate for Payer: BCBS MAPPO |
$1,039.05
|
| Rate for Payer: BCN Commercial |
$1,831.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,039.05
|
| Rate for Payer: Cash Price |
$2,135.20
|
| Rate for Payer: Cash Price |
$2,135.20
|
| Rate for Payer: Cofinity Commercial |
$1,496.23
|
| Rate for Payer: Cofinity Commercial |
$1,392.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,039.05
|
| Rate for Payer: Healthscope Commercial |
$1,246.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,246.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,091.00
|
| Rate for Payer: Meridian Medicaid |
$704.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,142.95
|
| Rate for Payer: Nomi Health Commercial |
$1,246.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,001.75
|
| Rate for Payer: PACE SWMI |
$1,039.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,039.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$670.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,724.33
|
| Rate for Payer: Priority Health Medicare |
$1,039.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,724.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,039.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,143.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,039.05
|
| Rate for Payer: UHC Exchange |
$2,143.87
|
| Rate for Payer: UHC Medicaid |
$670.95
|
| Rate for Payer: UHCCP DNSP |
$1,039.05
|
| Rate for Payer: UHCCP Medicaid |
$670.95
|
|
|
PR NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY
|
Professional
|
Both
|
$948.00
|
|
|
Service Code
|
HCPCS 31257
|
| Min. Negotiated Rate |
$239.20 |
| Max. Negotiated Rate |
$785.07 |
| Rate for Payer: Aetna Commercial |
$500.29
|
| Rate for Payer: Aetna Medicare |
$373.35
|
| Rate for Payer: BCBS Complete |
$251.16
|
| Rate for Payer: BCBS MAPPO |
$373.35
|
| Rate for Payer: BCN Commercial |
$662.81
|
| Rate for Payer: BCN Medicare Advantage |
$373.35
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cofinity Commercial |
$537.62
|
| Rate for Payer: Cofinity Commercial |
$500.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.35
|
| Rate for Payer: Healthscope Commercial |
$448.02
|
| Rate for Payer: Healthscope Whirlpool |
$448.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.02
|
| Rate for Payer: Meridian Medicaid |
$251.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.69
|
| Rate for Payer: Nomi Health Commercial |
$448.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.00
|
| Rate for Payer: PACE SWMI |
$373.35
|
| Rate for Payer: PHP Medicare Advantage |
$373.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$624.17
|
| Rate for Payer: Priority Health Medicare |
$373.35
|
| Rate for Payer: Priority Health Narrow Network |
$624.17
|
| Rate for Payer: Railroad Medicare Medicare |
$373.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$785.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.35
|
| Rate for Payer: UHC Exchange |
$785.07
|
| Rate for Payer: UHC Medicaid |
$239.20
|
| Rate for Payer: UHCCP DNSP |
$373.35
|
| Rate for Payer: UHCCP Medicaid |
$239.20
|
|
|
PR NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 31253
|
| Min. Negotiated Rate |
$267.95 |
| Max. Negotiated Rate |
$881.97 |
| Rate for Payer: Aetna Commercial |
$560.72
|
| Rate for Payer: Aetna Medicare |
$418.45
|
| Rate for Payer: BCBS Complete |
$281.35
|
| Rate for Payer: BCBS MAPPO |
$418.45
|
| Rate for Payer: BCN Commercial |
$742.99
|
| Rate for Payer: BCN Medicare Advantage |
$418.45
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$602.57
|
| Rate for Payer: Cofinity Commercial |
$560.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$418.45
|
| Rate for Payer: Healthscope Commercial |
$502.14
|
| Rate for Payer: Healthscope Whirlpool |
$502.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$439.37
|
| Rate for Payer: Meridian Medicaid |
$281.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$460.30
|
| Rate for Payer: Nomi Health Commercial |
$502.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$787.50
|
| Rate for Payer: PACE SWMI |
$418.45
|
| Rate for Payer: PHP Medicare Advantage |
$418.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$699.67
|
| Rate for Payer: Priority Health Medicare |
$418.45
|
| Rate for Payer: Priority Health Narrow Network |
$699.67
|
| Rate for Payer: Railroad Medicare Medicare |
$418.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$881.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$418.45
|
| Rate for Payer: UHC Exchange |
$881.97
|
| Rate for Payer: UHC Medicaid |
$267.95
|
| Rate for Payer: UHCCP DNSP |
$418.45
|
| Rate for Payer: UHCCP Medicaid |
$267.95
|
|
|
PR NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL
|
Professional
|
Both
|
$1,004.00
|
|
|
Service Code
|
HCPCS 31259
|
| Min. Negotiated Rate |
$253.26 |
| Max. Negotiated Rate |
$831.09 |
| Rate for Payer: Aetna Commercial |
$529.86
|
| Rate for Payer: Aetna Medicare |
$395.42
|
| Rate for Payer: BCBS Complete |
$265.92
|
| Rate for Payer: BCBS MAPPO |
$395.42
|
| Rate for Payer: BCN Commercial |
$701.65
|
| Rate for Payer: BCN Medicare Advantage |
$395.42
|
| Rate for Payer: Cash Price |
$803.20
|
| Rate for Payer: Cash Price |
$803.20
|
| Rate for Payer: Cofinity Commercial |
$569.40
|
| Rate for Payer: Cofinity Commercial |
$529.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.42
|
| Rate for Payer: Healthscope Commercial |
$474.50
|
| Rate for Payer: Healthscope Whirlpool |
$474.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.19
|
| Rate for Payer: Meridian Medicaid |
$265.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$434.96
|
| Rate for Payer: Nomi Health Commercial |
$474.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$753.00
|
| Rate for Payer: PACE SWMI |
$395.42
|
| Rate for Payer: PHP Medicare Advantage |
$395.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$660.75
|
| Rate for Payer: Priority Health Medicare |
$395.42
|
| Rate for Payer: Priority Health Narrow Network |
$660.75
|
| Rate for Payer: Railroad Medicare Medicare |
$395.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$831.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$395.42
|
| Rate for Payer: UHC Exchange |
$831.09
|
| Rate for Payer: UHC Medicaid |
$253.26
|
| Rate for Payer: UHCCP DNSP |
$395.42
|
| Rate for Payer: UHCCP Medicaid |
$253.26
|
|
|
PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 31254
|
| Min. Negotiated Rate |
$131.21 |
| Max. Negotiated Rate |
$573.75 |
| Rate for Payer: Aetna Commercial |
$273.72
|
| Rate for Payer: Aetna Medicare |
$204.27
|
| Rate for Payer: BCBS Complete |
$137.77
|
| Rate for Payer: BCBS MAPPO |
$204.27
|
| Rate for Payer: BCN Commercial |
$362.53
|
| Rate for Payer: BCN Medicare Advantage |
$204.27
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$294.15
|
| Rate for Payer: Cofinity Commercial |
$273.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.27
|
| Rate for Payer: Healthscope Commercial |
$245.12
|
| Rate for Payer: Healthscope Whirlpool |
$245.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.48
|
| Rate for Payer: Meridian Medicaid |
$137.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$224.70
|
| Rate for Payer: Nomi Health Commercial |
$245.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$573.75
|
| Rate for Payer: PACE SWMI |
$204.27
|
| Rate for Payer: PHP Medicare Advantage |
$204.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$341.39
|
| Rate for Payer: Priority Health Medicare |
$204.27
|
| Rate for Payer: Priority Health Narrow Network |
$341.39
|
| Rate for Payer: Railroad Medicare Medicare |
$204.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$426.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$204.27
|
| Rate for Payer: UHC Exchange |
$426.91
|
| Rate for Payer: UHC Medicaid |
$131.21
|
| Rate for Payer: UHCCP DNSP |
$204.27
|
| Rate for Payer: UHCCP Medicaid |
$131.21
|
|
|
PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS
|
Professional
|
Both
|
$1,401.00
|
|
|
Service Code
|
HCPCS 31276
|
| Min. Negotiated Rate |
$202.78 |
| Max. Negotiated Rate |
$1,050.75 |
| Rate for Payer: Aetna Commercial |
$423.92
|
| Rate for Payer: Aetna Medicare |
$316.36
|
| Rate for Payer: BCBS Complete |
$212.92
|
| Rate for Payer: BCBS MAPPO |
$316.36
|
| Rate for Payer: BCN Commercial |
$562.72
|
| Rate for Payer: BCN Medicare Advantage |
$316.36
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cofinity Commercial |
$455.56
|
| Rate for Payer: Cofinity Commercial |
$423.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.36
|
| Rate for Payer: Healthscope Commercial |
$379.63
|
| Rate for Payer: Healthscope Whirlpool |
$379.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.18
|
| Rate for Payer: Meridian Medicaid |
$212.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$348.00
|
| Rate for Payer: Nomi Health Commercial |
$379.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,050.75
|
| Rate for Payer: PACE SWMI |
$316.36
|
| Rate for Payer: PHP Medicare Advantage |
$316.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$529.92
|
| Rate for Payer: Priority Health Medicare |
$316.36
|
| Rate for Payer: Priority Health Narrow Network |
$529.92
|
| Rate for Payer: Railroad Medicare Medicare |
$316.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$664.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$316.36
|
| Rate for Payer: UHC Exchange |
$664.82
|
| Rate for Payer: UHC Medicaid |
$202.78
|
| Rate for Payer: UHCCP DNSP |
$316.36
|
| Rate for Payer: UHCCP Medicaid |
$202.78
|
|
|
PR NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY
|
Professional
|
Both
|
$973.00
|
|
|
Service Code
|
HCPCS 31255
|
| Min. Negotiated Rate |
$174.23 |
| Max. Negotiated Rate |
$729.75 |
| Rate for Payer: Aetna Commercial |
$364.04
|
| Rate for Payer: Aetna Medicare |
$271.67
|
| Rate for Payer: BCBS Complete |
$182.94
|
| Rate for Payer: BCBS MAPPO |
$271.67
|
| Rate for Payer: BCN Commercial |
$481.05
|
| Rate for Payer: BCN Medicare Advantage |
$271.67
|
| Rate for Payer: Cash Price |
$778.40
|
| Rate for Payer: Cash Price |
$778.40
|
| Rate for Payer: Cofinity Commercial |
$391.20
|
| Rate for Payer: Cofinity Commercial |
$364.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.67
|
| Rate for Payer: Healthscope Commercial |
$326.00
|
| Rate for Payer: Healthscope Whirlpool |
$326.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$285.25
|
| Rate for Payer: Meridian Medicaid |
$182.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$298.84
|
| Rate for Payer: Nomi Health Commercial |
$326.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$729.75
|
| Rate for Payer: PACE SWMI |
$271.67
|
| Rate for Payer: PHP Medicare Advantage |
$271.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$453.01
|
| Rate for Payer: Priority Health Medicare |
$271.67
|
| Rate for Payer: Priority Health Narrow Network |
$453.01
|
| Rate for Payer: Railroad Medicare Medicare |
$271.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$569.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$271.67
|
| Rate for Payer: UHC Exchange |
$569.80
|
| Rate for Payer: UHC Medicaid |
$174.23
|
| Rate for Payer: UHCCP DNSP |
$271.67
|
| Rate for Payer: UHCCP Medicaid |
$174.23
|
|
|
PR NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 43752
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$92.25 |
| Rate for Payer: Aetna Commercial |
$46.03
|
| Rate for Payer: Aetna Medicare |
$34.35
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCBS MAPPO |
$34.35
|
| Rate for Payer: BCN Commercial |
$59.26
|
| Rate for Payer: BCN Medicare Advantage |
$34.35
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$49.46
|
| Rate for Payer: Cofinity Commercial |
$46.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.35
|
| Rate for Payer: Healthscope Commercial |
$41.22
|
| Rate for Payer: Healthscope Whirlpool |
$41.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.07
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.78
|
| Rate for Payer: Nomi Health Commercial |
$41.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.25
|
| Rate for Payer: PACE SWMI |
$34.35
|
| Rate for Payer: PHP Medicare Advantage |
$34.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.20
|
| Rate for Payer: Priority Health Medicare |
$34.35
|
| Rate for Payer: Priority Health Narrow Network |
$72.20
|
| Rate for Payer: Railroad Medicare Medicare |
$34.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.35
|
| Rate for Payer: UHC Exchange |
$72.59
|
| Rate for Payer: UHC Medicaid |
$21.94
|
| Rate for Payer: UHCCP DNSP |
$34.35
|
| Rate for Payer: UHCCP Medicaid |
$21.94
|
|
|
PR NASOPHARYNGOSCOPY W/ENDOSCOPE SPX
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 92511
|
| Min. Negotiated Rate |
$20.87 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Aetna Commercial |
$42.73
|
| Rate for Payer: Aetna Medicare |
$31.89
|
| Rate for Payer: BCBS Complete |
$21.91
|
| Rate for Payer: BCBS MAPPO |
$31.89
|
| Rate for Payer: BCN Commercial |
$44.77
|
| Rate for Payer: BCN Medicare Advantage |
$31.89
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$42.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.89
|
| Rate for Payer: Healthscope Commercial |
$38.27
|
| Rate for Payer: Healthscope Whirlpool |
$38.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.48
|
| Rate for Payer: Meridian Medicaid |
$21.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.08
|
| Rate for Payer: Nomi Health Commercial |
$38.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.50
|
| Rate for Payer: PACE SWMI |
$31.89
|
| Rate for Payer: PHP Medicare Advantage |
$31.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$52.36
|
| Rate for Payer: Priority Health Medicare |
$31.89
|
| Rate for Payer: Priority Health Narrow Network |
$52.36
|
| Rate for Payer: Railroad Medicare Medicare |
$31.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.89
|
| Rate for Payer: UHC Exchange |
$60.68
|
| Rate for Payer: UHC Medicaid |
$20.87
|
| Rate for Payer: UHCCP DNSP |
$31.89
|
| Rate for Payer: UHCCP Medicaid |
$20.87
|
|
|
PR NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 95860
|
| Min. Negotiated Rate |
$112.26 |
| Max. Negotiated Rate |
$185.79 |
| Rate for Payer: Aetna Commercial |
$150.43
|
| Rate for Payer: Aetna Medicare |
$112.26
|
| Rate for Payer: BCBS MAPPO |
$112.26
|
| Rate for Payer: BCN Commercial |
$164.83
|
| Rate for Payer: BCN Medicare Advantage |
$112.26
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$150.43
|
| Rate for Payer: Cofinity Commercial |
$161.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.26
|
| Rate for Payer: Healthscope Commercial |
$134.71
|
| Rate for Payer: Healthscope Whirlpool |
$134.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.49
|
| Rate for Payer: Nomi Health Commercial |
$134.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE SWMI |
$112.26
|
| Rate for Payer: PHP Medicare Advantage |
$112.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$152.01
|
| Rate for Payer: Priority Health Medicare |
$112.26
|
| Rate for Payer: Priority Health Narrow Network |
$152.01
|
| Rate for Payer: Railroad Medicare Medicare |
$112.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.26
|
| Rate for Payer: UHC Exchange |
$185.79
|
| Rate for Payer: UHCCP DNSP |
$112.26
|
|
|
PR NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 95861
|
| Min. Negotiated Rate |
$152.84 |
| Max. Negotiated Rate |
$266.95 |
| Rate for Payer: Aetna Commercial |
$204.81
|
| Rate for Payer: Aetna Medicare |
$152.84
|
| Rate for Payer: BCBS MAPPO |
$152.84
|
| Rate for Payer: BCN Commercial |
$230.07
|
| Rate for Payer: BCN Medicare Advantage |
$152.84
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$204.81
|
| Rate for Payer: Cofinity Commercial |
$220.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.84
|
| Rate for Payer: Healthscope Commercial |
$183.41
|
| Rate for Payer: Healthscope Whirlpool |
$183.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.12
|
| Rate for Payer: Nomi Health Commercial |
$183.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.75
|
| Rate for Payer: PACE SWMI |
$152.84
|
| Rate for Payer: PHP Medicare Advantage |
$152.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$212.17
|
| Rate for Payer: Priority Health Medicare |
$152.84
|
| Rate for Payer: Priority Health Narrow Network |
$212.17
|
| Rate for Payer: Railroad Medicare Medicare |
$152.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$266.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$152.84
|
| Rate for Payer: UHC Exchange |
$266.95
|
| Rate for Payer: UHCCP DNSP |
$152.84
|
|
|
PR NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 95863
|
| Min. Negotiated Rate |
$207.21 |
| Max. Negotiated Rate |
$329.73 |
| Rate for Payer: Aetna Commercial |
$277.66
|
| Rate for Payer: Aetna Medicare |
$207.21
|
| Rate for Payer: BCBS MAPPO |
$207.21
|
| Rate for Payer: BCN Commercial |
$312.73
|
| Rate for Payer: BCN Medicare Advantage |
$207.21
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cofinity Commercial |
$277.66
|
| Rate for Payer: Cofinity Commercial |
$298.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.21
|
| Rate for Payer: Healthscope Commercial |
$248.65
|
| Rate for Payer: Healthscope Whirlpool |
$248.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$217.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$227.93
|
| Rate for Payer: Nomi Health Commercial |
$248.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.00
|
| Rate for Payer: PACE SWMI |
$207.21
|
| Rate for Payer: PHP Medicare Advantage |
$207.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$288.41
|
| Rate for Payer: Priority Health Medicare |
$207.21
|
| Rate for Payer: Priority Health Narrow Network |
$288.41
|
| Rate for Payer: Railroad Medicare Medicare |
$207.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$207.21
|
| Rate for Payer: UHC Exchange |
$329.73
|
| Rate for Payer: UHCCP DNSP |
$207.21
|
|
|
PR NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$425.00
|
|
|
Service Code
|
HCPCS 95864
|
| Min. Negotiated Rate |
$225.85 |
| Max. Negotiated Rate |
$386.19 |
| Rate for Payer: Aetna Commercial |
$302.64
|
| Rate for Payer: Aetna Medicare |
$225.85
|
| Rate for Payer: BCBS MAPPO |
$225.85
|
| Rate for Payer: BCN Commercial |
$330.66
|
| Rate for Payer: BCN Medicare Advantage |
$225.85
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cofinity Commercial |
$302.64
|
| Rate for Payer: Cofinity Commercial |
$325.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.85
|
| Rate for Payer: Healthscope Commercial |
$271.02
|
| Rate for Payer: Healthscope Whirlpool |
$271.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.44
|
| Rate for Payer: Nomi Health Commercial |
$271.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.75
|
| Rate for Payer: PACE SWMI |
$225.85
|
| Rate for Payer: PHP Medicare Advantage |
$225.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$304.94
|
| Rate for Payer: Priority Health Medicare |
$225.85
|
| Rate for Payer: Priority Health Narrow Network |
$304.94
|
| Rate for Payer: Railroad Medicare Medicare |
$225.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$225.85
|
| Rate for Payer: UHC Exchange |
$386.19
|
| Rate for Payer: UHCCP DNSP |
$225.85
|
|
|
PR NDL OCULOELECTROMYOGRAPHY 1+EO MUSC 1/BOTH EYE
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
HCPCS 92265
|
| Min. Negotiated Rate |
$57.00 |
| Max. Negotiated Rate |
$129.97 |
| Rate for Payer: Aetna Commercial |
$111.15
|
| Rate for Payer: Aetna Medicare |
$82.95
|
| Rate for Payer: BCBS MAPPO |
$82.95
|
| Rate for Payer: BCN Commercial |
$129.97
|
| Rate for Payer: BCN Medicare Advantage |
$82.95
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$111.15
|
| Rate for Payer: Cofinity Commercial |
$119.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.95
|
| Rate for Payer: Healthscope Commercial |
$99.54
|
| Rate for Payer: Healthscope Whirlpool |
$99.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.25
|
| Rate for Payer: Nomi Health Commercial |
$99.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.00
|
| Rate for Payer: PACE SWMI |
$82.95
|
| Rate for Payer: PHP Medicare Advantage |
$82.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.21
|
| Rate for Payer: Priority Health Medicare |
$82.95
|
| Rate for Payer: Priority Health Narrow Network |
$111.21
|
| Rate for Payer: Railroad Medicare Medicare |
$82.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.95
|
| Rate for Payer: UHC Exchange |
$105.61
|
| Rate for Payer: UHCCP DNSP |
$82.95
|
|
