|
PR NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV
|
Professional
|
Both
|
$1,027.00
|
|
|
Service Code
|
HCPCS 64712
|
| Min. Negotiated Rate |
$355.50 |
| Max. Negotiated Rate |
$1,050.95 |
| Rate for Payer: Aetna Commercial |
$728.89
|
| Rate for Payer: Aetna Medicare |
$543.95
|
| Rate for Payer: BCBS Complete |
$373.27
|
| Rate for Payer: BCBS MAPPO |
$543.95
|
| Rate for Payer: BCN Commercial |
$904.83
|
| Rate for Payer: BCN Medicare Advantage |
$543.95
|
| Rate for Payer: Cash Price |
$821.60
|
| Rate for Payer: Cash Price |
$821.60
|
| Rate for Payer: Cofinity Commercial |
$783.29
|
| Rate for Payer: Cofinity Commercial |
$728.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.95
|
| Rate for Payer: Healthscope Commercial |
$652.74
|
| Rate for Payer: Healthscope Whirlpool |
$652.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.15
|
| Rate for Payer: Meridian Medicaid |
$373.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.35
|
| Rate for Payer: Nomi Health Commercial |
$652.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$770.25
|
| Rate for Payer: PACE SWMI |
$543.95
|
| Rate for Payer: PHP Medicare Advantage |
$543.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,050.95
|
| Rate for Payer: Priority Health Medicare |
$543.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,050.95
|
| Rate for Payer: Railroad Medicare Medicare |
$543.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,025.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$543.95
|
| Rate for Payer: UHC Exchange |
$1,025.33
|
| Rate for Payer: UHC Medicaid |
$355.50
|
| Rate for Payer: UHCCP DNSP |
$543.95
|
| Rate for Payer: UHCCP Medicaid |
$355.50
|
|
|
PR N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI
|
Professional
|
Both
|
$329.00
|
|
|
Service Code
|
HCPCS 93924
|
| Min. Negotiated Rate |
$153.02 |
| Max. Negotiated Rate |
$248.44 |
| Rate for Payer: Aetna Commercial |
$205.05
|
| Rate for Payer: Aetna Medicare |
$153.02
|
| Rate for Payer: BCBS MAPPO |
$153.02
|
| Rate for Payer: BCN Commercial |
$237.54
|
| Rate for Payer: BCN Medicare Advantage |
$153.02
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Cofinity Commercial |
$205.05
|
| Rate for Payer: Cofinity Commercial |
$220.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.02
|
| Rate for Payer: Healthscope Commercial |
$183.62
|
| Rate for Payer: Healthscope Whirlpool |
$183.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.32
|
| Rate for Payer: Nomi Health Commercial |
$183.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.75
|
| Rate for Payer: PACE SWMI |
$153.02
|
| Rate for Payer: PHP Medicare Advantage |
$153.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$219.06
|
| Rate for Payer: Priority Health Medicare |
$153.02
|
| Rate for Payer: Priority Health Narrow Network |
$219.06
|
| Rate for Payer: Railroad Medicare Medicare |
$153.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$153.02
|
| Rate for Payer: UHC Exchange |
$248.44
|
| Rate for Payer: UHCCP DNSP |
$153.02
|
|
|
PR NIPPLE/AREOLA RECONSTRUCTION
|
Professional
|
Both
|
$1,576.00
|
|
|
Service Code
|
HCPCS 19350
|
| Min. Negotiated Rate |
$392.77 |
| Max. Negotiated Rate |
$1,182.00 |
| Rate for Payer: Aetna Commercial |
$804.24
|
| Rate for Payer: Aetna Medicare |
$600.18
|
| Rate for Payer: BCBS Complete |
$412.41
|
| Rate for Payer: BCBS MAPPO |
$600.18
|
| Rate for Payer: BCN Commercial |
$1,020.86
|
| Rate for Payer: BCN Medicare Advantage |
$600.18
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cofinity Commercial |
$864.26
|
| Rate for Payer: Cofinity Commercial |
$804.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.18
|
| Rate for Payer: Healthscope Commercial |
$720.22
|
| Rate for Payer: Healthscope Whirlpool |
$720.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.19
|
| Rate for Payer: Meridian Medicaid |
$412.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$660.20
|
| Rate for Payer: Nomi Health Commercial |
$720.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,182.00
|
| Rate for Payer: PACE SWMI |
$600.18
|
| Rate for Payer: PHP Medicare Advantage |
$600.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$934.35
|
| Rate for Payer: Priority Health Medicare |
$600.18
|
| Rate for Payer: Priority Health Narrow Network |
$934.35
|
| Rate for Payer: Railroad Medicare Medicare |
$600.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,173.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$600.18
|
| Rate for Payer: UHC Exchange |
$1,173.53
|
| Rate for Payer: UHC Medicaid |
$392.77
|
| Rate for Payer: UHCCP DNSP |
$600.18
|
| Rate for Payer: UHCCP Medicaid |
$392.77
|
|
|
PR NIPPLE EXPLORATION
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 19110
|
| Min. Negotiated Rate |
$226.85 |
| Max. Negotiated Rate |
$604.39 |
| Rate for Payer: Aetna Commercial |
$462.98
|
| Rate for Payer: Aetna Medicare |
$345.51
|
| Rate for Payer: BCBS Complete |
$238.19
|
| Rate for Payer: BCBS MAPPO |
$345.51
|
| Rate for Payer: BCN Commercial |
$537.33
|
| Rate for Payer: BCN Medicare Advantage |
$345.51
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$497.53
|
| Rate for Payer: Cofinity Commercial |
$462.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.51
|
| Rate for Payer: Healthscope Commercial |
$414.61
|
| Rate for Payer: Healthscope Whirlpool |
$414.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.79
|
| Rate for Payer: Meridian Medicaid |
$238.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$380.06
|
| Rate for Payer: Nomi Health Commercial |
$414.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.25
|
| Rate for Payer: PACE SWMI |
$345.51
|
| Rate for Payer: PHP Medicare Advantage |
$345.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$491.79
|
| Rate for Payer: Priority Health Medicare |
$345.51
|
| Rate for Payer: Priority Health Narrow Network |
$491.79
|
| Rate for Payer: Railroad Medicare Medicare |
$345.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$604.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$345.51
|
| Rate for Payer: UHC Exchange |
$604.39
|
| Rate for Payer: UHC Medicaid |
$226.85
|
| Rate for Payer: UHCCP DNSP |
$345.51
|
| Rate for Payer: UHCCP Medicaid |
$226.85
|
|
|
PR NITRIC OXIDE EXPIRED GAS DETERMINATION
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 95012
|
| Min. Negotiated Rate |
$18.06 |
| Max. Negotiated Rate |
$29.82 |
| Rate for Payer: Aetna Commercial |
$24.20
|
| Rate for Payer: Aetna Medicare |
$18.06
|
| Rate for Payer: BCBS MAPPO |
$18.06
|
| Rate for Payer: BCN Commercial |
$27.89
|
| Rate for Payer: BCN Medicare Advantage |
$18.06
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$24.20
|
| Rate for Payer: Cofinity Commercial |
$26.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.06
|
| Rate for Payer: Healthscope Commercial |
$21.67
|
| Rate for Payer: Healthscope Whirlpool |
$21.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.87
|
| Rate for Payer: Nomi Health Commercial |
$21.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: PACE SWMI |
$18.06
|
| Rate for Payer: PHP Medicare Advantage |
$18.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$26.24
|
| Rate for Payer: Priority Health Medicare |
$18.06
|
| Rate for Payer: Priority Health Narrow Network |
$26.24
|
| Rate for Payer: Railroad Medicare Medicare |
$18.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.06
|
| Rate for Payer: UHC Exchange |
$29.82
|
| Rate for Payer: UHCCP DNSP |
$18.06
|
|
|
PR NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 64455
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$40.29
|
| Rate for Payer: Aetna Medicare |
$30.07
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$30.07
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: BCN Medicare Advantage |
$30.07
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$40.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.07
|
| Rate for Payer: Healthscope Commercial |
$36.08
|
| Rate for Payer: Healthscope Whirlpool |
$36.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.57
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.08
|
| Rate for Payer: Nomi Health Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$30.07
|
| Rate for Payer: PHP Medicare Advantage |
$30.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$57.26
|
| Rate for Payer: Priority Health Medicare |
$30.07
|
| Rate for Payer: Priority Health Narrow Network |
$57.26
|
| Rate for Payer: Railroad Medicare Medicare |
$30.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.07
|
| Rate for Payer: UHC Exchange |
$61.77
|
| Rate for Payer: UHC Medicaid |
$19.17
|
| Rate for Payer: UHCCP DNSP |
$30.07
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
|
|
PR NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 64479
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$153.23
|
| Rate for Payer: Aetna Commercial |
$153.23
|
| Rate for Payer: Aetna Medicare |
$114.35
|
| Rate for Payer: Aetna Medicare |
$114.35
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$114.35
|
| Rate for Payer: BCBS MAPPO |
$114.35
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Medicare Advantage |
$114.35
|
| Rate for Payer: BCN Medicare Advantage |
$114.35
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cofinity Commercial |
$153.23
|
| Rate for Payer: Cofinity Commercial |
$164.66
|
| Rate for Payer: Cofinity Commercial |
$153.23
|
| Rate for Payer: Cofinity Commercial |
$164.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.35
|
| Rate for Payer: Healthscope Commercial |
$137.22
|
| Rate for Payer: Healthscope Commercial |
$137.22
|
| Rate for Payer: Healthscope Whirlpool |
$137.22
|
| Rate for Payer: Healthscope Whirlpool |
$137.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.07
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.78
|
| Rate for Payer: Nomi Health Commercial |
$137.22
|
| Rate for Payer: Nomi Health Commercial |
$137.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$690.00
|
| Rate for Payer: PACE SWMI |
$114.35
|
| Rate for Payer: PACE SWMI |
$114.35
|
| Rate for Payer: PHP Medicare Advantage |
$114.35
|
| Rate for Payer: PHP Medicare Advantage |
$114.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$226.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$226.73
|
| Rate for Payer: Priority Health Medicare |
$114.35
|
| Rate for Payer: Priority Health Medicare |
$114.35
|
| Rate for Payer: Priority Health Narrow Network |
$226.73
|
| Rate for Payer: Priority Health Narrow Network |
$226.73
|
| Rate for Payer: Railroad Medicare Medicare |
$114.35
|
| Rate for Payer: Railroad Medicare Medicare |
$114.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.35
|
| Rate for Payer: UHC Exchange |
$229.99
|
| Rate for Payer: UHC Exchange |
$229.99
|
| Rate for Payer: UHC Medicaid |
$74.34
|
| Rate for Payer: UHC Medicaid |
$74.34
|
| Rate for Payer: UHCCP DNSP |
$114.35
|
| Rate for Payer: UHCCP DNSP |
$114.35
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
|
PR NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 64480
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$267.00 |
| Rate for Payer: Aetna Commercial |
$70.59
|
| Rate for Payer: Aetna Medicare |
$52.68
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$52.68
|
| Rate for Payer: BCN Commercial |
$91.63
|
| Rate for Payer: BCN Medicare Advantage |
$52.68
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cofinity Commercial |
$70.59
|
| Rate for Payer: Cofinity Commercial |
$75.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.68
|
| Rate for Payer: Healthscope Commercial |
$63.22
|
| Rate for Payer: Healthscope Whirlpool |
$63.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.31
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.95
|
| Rate for Payer: Nomi Health Commercial |
$63.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.00
|
| Rate for Payer: PACE SWMI |
$52.68
|
| Rate for Payer: PHP Medicare Advantage |
$52.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$106.43
|
| Rate for Payer: Priority Health Medicare |
$52.68
|
| Rate for Payer: Priority Health Narrow Network |
$106.43
|
| Rate for Payer: Railroad Medicare Medicare |
$52.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.68
|
| Rate for Payer: UHC Exchange |
$110.46
|
| Rate for Payer: UHC Medicaid |
$33.87
|
| Rate for Payer: UHCCP DNSP |
$52.68
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
|
|
PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 64483
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Aetna Commercial |
$130.62
|
| Rate for Payer: Aetna Commercial |
$130.62
|
| Rate for Payer: Aetna Medicare |
$97.48
|
| Rate for Payer: Aetna Medicare |
$97.48
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$97.48
|
| Rate for Payer: BCBS MAPPO |
$97.48
|
| Rate for Payer: BCN Commercial |
$165.83
|
| Rate for Payer: BCN Commercial |
$165.83
|
| Rate for Payer: BCN Medicare Advantage |
$97.48
|
| Rate for Payer: BCN Medicare Advantage |
$97.48
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cofinity Commercial |
$130.62
|
| Rate for Payer: Cofinity Commercial |
$130.62
|
| Rate for Payer: Cofinity Commercial |
$140.37
|
| Rate for Payer: Cofinity Commercial |
$140.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.48
|
| Rate for Payer: Healthscope Commercial |
$116.98
|
| Rate for Payer: Healthscope Commercial |
$116.98
|
| Rate for Payer: Healthscope Whirlpool |
$116.98
|
| Rate for Payer: Healthscope Whirlpool |
$116.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.35
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.23
|
| Rate for Payer: Nomi Health Commercial |
$116.98
|
| Rate for Payer: Nomi Health Commercial |
$116.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$788.25
|
| Rate for Payer: PACE SWMI |
$97.48
|
| Rate for Payer: PACE SWMI |
$97.48
|
| Rate for Payer: PHP Medicare Advantage |
$97.48
|
| Rate for Payer: PHP Medicare Advantage |
$97.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$192.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$192.60
|
| Rate for Payer: Priority Health Medicare |
$97.48
|
| Rate for Payer: Priority Health Medicare |
$97.48
|
| Rate for Payer: Priority Health Narrow Network |
$192.60
|
| Rate for Payer: Priority Health Narrow Network |
$192.60
|
| Rate for Payer: Railroad Medicare Medicare |
$97.48
|
| Rate for Payer: Railroad Medicare Medicare |
$97.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.48
|
| Rate for Payer: UHC Exchange |
$195.52
|
| Rate for Payer: UHC Exchange |
$195.52
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP DNSP |
$97.48
|
| Rate for Payer: UHCCP DNSP |
$97.48
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL
|
Professional
|
Both
|
$458.00
|
|
|
Service Code
|
HCPCS 64484
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$343.50 |
| Rate for Payer: Aetna Commercial |
$58.12
|
| Rate for Payer: Aetna Medicare |
$43.37
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$43.37
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: BCN Medicare Advantage |
$43.37
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cofinity Commercial |
$58.12
|
| Rate for Payer: Cofinity Commercial |
$62.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.37
|
| Rate for Payer: Healthscope Commercial |
$52.04
|
| Rate for Payer: Healthscope Whirlpool |
$52.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.54
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.71
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.50
|
| Rate for Payer: PACE SWMI |
$43.37
|
| Rate for Payer: PHP Medicare Advantage |
$43.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$87.33
|
| Rate for Payer: Priority Health Medicare |
$43.37
|
| Rate for Payer: Priority Health Narrow Network |
$87.33
|
| Rate for Payer: Railroad Medicare Medicare |
$43.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.37
|
| Rate for Payer: UHC Exchange |
$91.99
|
| Rate for Payer: UHC Medicaid |
$27.90
|
| Rate for Payer: UHCCP DNSP |
$43.37
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR NJX BONE SUB MATRL INTO SUBCHONDRAL BONE DEFECT
|
Professional
|
Both
|
$3,152.00
|
|
|
Service Code
|
HCPCS 0707T
|
| Min. Negotiated Rate |
$368.07 |
| Max. Negotiated Rate |
$3,033.71 |
| Rate for Payer: Aetna Commercial |
$368.07
|
| Rate for Payer: BCBS Complete |
$1,260.80
|
| Rate for Payer: BCN Commercial |
$3,033.71
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,364.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$638.56
|
| Rate for Payer: UHC Exchange |
$638.56
|
|
|
PR NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 51600
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$532.50 |
| Rate for Payer: Aetna Commercial |
$49.98
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS MAPPO |
$37.30
|
| Rate for Payer: BCN Commercial |
$63.74
|
| Rate for Payer: BCN Medicare Advantage |
$37.30
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cofinity Commercial |
$53.71
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.30
|
| Rate for Payer: Healthscope Commercial |
$44.76
|
| Rate for Payer: Healthscope Whirlpool |
$44.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.16
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.03
|
| Rate for Payer: Nomi Health Commercial |
$44.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$532.50
|
| Rate for Payer: PACE SWMI |
$37.30
|
| Rate for Payer: PHP Medicare Advantage |
$37.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.43
|
| Rate for Payer: Priority Health Medicare |
$37.30
|
| Rate for Payer: Priority Health Narrow Network |
$69.43
|
| Rate for Payer: Railroad Medicare Medicare |
$37.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.30
|
| Rate for Payer: UHC Exchange |
$78.72
|
| Rate for Payer: UHC Medicaid |
$23.86
|
| Rate for Payer: UHCCP DNSP |
$37.30
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
|
|
PR NJX DRG C-CATHJ SLCTV L VNTRC/L ATRIAL ANGRPHS&I
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 93565
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$73.46 |
| Rate for Payer: Aetna Commercial |
$31.68
|
| Rate for Payer: Aetna Medicare |
$23.64
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCN Commercial |
$39.84
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$31.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$28.37
|
| Rate for Payer: Healthscope Whirlpool |
$28.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.00
|
| Rate for Payer: Nomi Health Commercial |
$28.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37.87
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow Network |
$37.87
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.64
|
| Rate for Payer: UHC Exchange |
$73.46
|
| Rate for Payer: UHC Medicaid |
$14.91
|
| Rate for Payer: UHCCP DNSP |
$23.64
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
|
PR NJX DRG C-CATHJ SLCTV R VNTRC/R ATRIAL ANGRPHS&I
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 93566
|
| Min. Negotiated Rate |
$14.27 |
| Max. Negotiated Rate |
$222.75 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$22.43
|
| Rate for Payer: BCBS Complete |
$14.98
|
| Rate for Payer: BCBS MAPPO |
$22.43
|
| Rate for Payer: BCN Commercial |
$37.85
|
| Rate for Payer: BCN Medicare Advantage |
$22.43
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$32.30
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.43
|
| Rate for Payer: Healthscope Commercial |
$26.92
|
| Rate for Payer: Healthscope Whirlpool |
$26.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.55
|
| Rate for Payer: Meridian Medicaid |
$14.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.67
|
| Rate for Payer: Nomi Health Commercial |
$26.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.75
|
| Rate for Payer: PACE SWMI |
$22.43
|
| Rate for Payer: PHP Medicare Advantage |
$22.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$35.97
|
| Rate for Payer: Priority Health Medicare |
$22.43
|
| Rate for Payer: Priority Health Narrow Network |
$35.97
|
| Rate for Payer: Railroad Medicare Medicare |
$22.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.43
|
| Rate for Payer: UHC Exchange |
$76.36
|
| Rate for Payer: UHC Medicaid |
$14.27
|
| Rate for Payer: UHCCP DNSP |
$22.43
|
| Rate for Payer: UHCCP Medicaid |
$14.27
|
|
|
PR NJX DRG C-CATHJ SUPRAVALVULAR AORTOGRAPHY S&I
|
Professional
|
Both
|
$440.00
|
|
|
Service Code
|
HCPCS 93567
|
| Min. Negotiated Rate |
$20.66 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$43.83
|
| Rate for Payer: Aetna Medicare |
$32.71
|
| Rate for Payer: BCBS Complete |
$21.69
|
| Rate for Payer: BCBS MAPPO |
$32.71
|
| Rate for Payer: BCN Commercial |
$54.78
|
| Rate for Payer: BCN Medicare Advantage |
$32.71
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cofinity Commercial |
$47.10
|
| Rate for Payer: Cofinity Commercial |
$43.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.71
|
| Rate for Payer: Healthscope Commercial |
$39.25
|
| Rate for Payer: Healthscope Whirlpool |
$39.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.35
|
| Rate for Payer: Meridian Medicaid |
$21.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.98
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.00
|
| Rate for Payer: PACE SWMI |
$32.71
|
| Rate for Payer: PHP Medicare Advantage |
$32.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$52.06
|
| Rate for Payer: Priority Health Medicare |
$32.71
|
| Rate for Payer: Priority Health Narrow Network |
$52.06
|
| Rate for Payer: Railroad Medicare Medicare |
$32.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.71
|
| Rate for Payer: UHC Exchange |
$87.21
|
| Rate for Payer: UHC Medicaid |
$20.66
|
| Rate for Payer: UHCCP DNSP |
$32.71
|
| Rate for Payer: UHCCP Medicaid |
$20.66
|
|
|
PR NJX DRG CGEN C-CATHJ SLCTV CORONARY ANGRPH S&I
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 93563
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$95.15 |
| Rate for Payer: Aetna Commercial |
$59.71
|
| Rate for Payer: Aetna Medicare |
$44.56
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$44.56
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: BCN Medicare Advantage |
$44.56
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$64.17
|
| Rate for Payer: Cofinity Commercial |
$59.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.56
|
| Rate for Payer: Healthscope Commercial |
$53.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.79
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.02
|
| Rate for Payer: Nomi Health Commercial |
$53.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: PACE SWMI |
$44.56
|
| Rate for Payer: PHP Medicare Advantage |
$44.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$71.46
|
| Rate for Payer: Priority Health Medicare |
$44.56
|
| Rate for Payer: Priority Health Narrow Network |
$71.46
|
| Rate for Payer: Railroad Medicare Medicare |
$44.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.56
|
| Rate for Payer: UHC Exchange |
$95.15
|
| Rate for Payer: UHC Medicaid |
$28.33
|
| Rate for Payer: UHCCP DNSP |
$44.56
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
|
|
PR NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 64490
|
| Min. Negotiated Rate |
$60.07 |
| Max. Negotiated Rate |
$261.75 |
| Rate for Payer: Aetna Commercial |
$123.78
|
| Rate for Payer: Aetna Medicare |
$92.37
|
| Rate for Payer: BCBS Complete |
$63.07
|
| Rate for Payer: BCBS MAPPO |
$92.37
|
| Rate for Payer: BCN Commercial |
$157.36
|
| Rate for Payer: BCN Medicare Advantage |
$92.37
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cofinity Commercial |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$123.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.37
|
| Rate for Payer: Healthscope Commercial |
$110.84
|
| Rate for Payer: Healthscope Whirlpool |
$110.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.99
|
| Rate for Payer: Meridian Medicaid |
$63.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.61
|
| Rate for Payer: Nomi Health Commercial |
$110.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.75
|
| Rate for Payer: PACE SWMI |
$92.37
|
| Rate for Payer: PHP Medicare Advantage |
$92.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$182.76
|
| Rate for Payer: Priority Health Medicare |
$92.37
|
| Rate for Payer: Priority Health Narrow Network |
$182.76
|
| Rate for Payer: Railroad Medicare Medicare |
$92.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$92.37
|
| Rate for Payer: UHC Exchange |
$185.34
|
| Rate for Payer: UHC Medicaid |
$60.07
|
| Rate for Payer: UHCCP DNSP |
$92.37
|
| Rate for Payer: UHCCP Medicaid |
$60.07
|
|
|
PR NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 64491
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Aetna Commercial |
$67.58
|
| Rate for Payer: Aetna Medicare |
$50.43
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS MAPPO |
$50.43
|
| Rate for Payer: BCN Commercial |
$88.64
|
| Rate for Payer: BCN Medicare Advantage |
$50.43
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$67.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.43
|
| Rate for Payer: Healthscope Commercial |
$60.52
|
| Rate for Payer: Healthscope Whirlpool |
$60.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.95
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.47
|
| Rate for Payer: Nomi Health Commercial |
$60.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.50
|
| Rate for Payer: PACE SWMI |
$50.43
|
| Rate for Payer: PHP Medicare Advantage |
$50.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.96
|
| Rate for Payer: Priority Health Medicare |
$50.43
|
| Rate for Payer: Priority Health Narrow Network |
$102.96
|
| Rate for Payer: Railroad Medicare Medicare |
$50.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.43
|
| Rate for Payer: UHC Exchange |
$106.17
|
| Rate for Payer: UHC Medicaid |
$32.38
|
| Rate for Payer: UHCCP DNSP |
$50.43
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
|
|
PR NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 64492
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Aetna Commercial |
$67.79
|
| Rate for Payer: Aetna Medicare |
$50.59
|
| Rate for Payer: BCBS Complete |
$34.22
|
| Rate for Payer: BCBS MAPPO |
$50.59
|
| Rate for Payer: BCN Commercial |
$89.14
|
| Rate for Payer: BCN Medicare Advantage |
$50.59
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$72.85
|
| Rate for Payer: Cofinity Commercial |
$67.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$60.71
|
| Rate for Payer: Healthscope Whirlpool |
$60.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.12
|
| Rate for Payer: Meridian Medicaid |
$34.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.65
|
| Rate for Payer: Nomi Health Commercial |
$60.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.50
|
| Rate for Payer: PACE SWMI |
$50.59
|
| Rate for Payer: PHP Medicare Advantage |
$50.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$103.53
|
| Rate for Payer: Priority Health Medicare |
$50.59
|
| Rate for Payer: Priority Health Narrow Network |
$103.53
|
| Rate for Payer: Railroad Medicare Medicare |
$50.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.59
|
| Rate for Payer: UHC Exchange |
$107.32
|
| Rate for Payer: UHC Medicaid |
$32.59
|
| Rate for Payer: UHCCP DNSP |
$50.59
|
| Rate for Payer: UHCCP Medicaid |
$32.59
|
|
|
PR NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 64493
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$186.75 |
| Rate for Payer: Aetna Commercial |
$106.82
|
| Rate for Payer: Aetna Medicare |
$79.72
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$79.72
|
| Rate for Payer: BCN Commercial |
$135.95
|
| Rate for Payer: BCN Medicare Advantage |
$79.72
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$114.80
|
| Rate for Payer: Cofinity Commercial |
$106.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.72
|
| Rate for Payer: Healthscope Commercial |
$95.66
|
| Rate for Payer: Healthscope Whirlpool |
$95.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.71
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.69
|
| Rate for Payer: Nomi Health Commercial |
$95.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.75
|
| Rate for Payer: PACE SWMI |
$79.72
|
| Rate for Payer: PHP Medicare Advantage |
$79.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$157.91
|
| Rate for Payer: Priority Health Medicare |
$79.72
|
| Rate for Payer: Priority Health Narrow Network |
$157.91
|
| Rate for Payer: Railroad Medicare Medicare |
$79.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.72
|
| Rate for Payer: UHC Exchange |
$157.04
|
| Rate for Payer: UHC Medicaid |
$51.97
|
| Rate for Payer: UHCCP DNSP |
$79.72
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
PR NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 64494
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Aetna Commercial |
$58.12
|
| Rate for Payer: Aetna Medicare |
$43.37
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$43.37
|
| Rate for Payer: BCN Commercial |
$75.70
|
| Rate for Payer: BCN Medicare Advantage |
$43.37
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$62.45
|
| Rate for Payer: Cofinity Commercial |
$58.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.37
|
| Rate for Payer: Healthscope Commercial |
$52.04
|
| Rate for Payer: Healthscope Whirlpool |
$52.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.54
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.71
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.00
|
| Rate for Payer: PACE SWMI |
$43.37
|
| Rate for Payer: PHP Medicare Advantage |
$43.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$87.92
|
| Rate for Payer: Priority Health Medicare |
$43.37
|
| Rate for Payer: Priority Health Narrow Network |
$87.92
|
| Rate for Payer: Railroad Medicare Medicare |
$43.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.37
|
| Rate for Payer: UHC Exchange |
$91.42
|
| Rate for Payer: UHC Medicaid |
$27.90
|
| Rate for Payer: UHCCP DNSP |
$43.37
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 64495
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: Aetna Commercial |
$59.75
|
| Rate for Payer: Aetna Medicare |
$44.59
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS MAPPO |
$44.59
|
| Rate for Payer: BCN Commercial |
$76.19
|
| Rate for Payer: BCN Medicare Advantage |
$44.59
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cofinity Commercial |
$59.75
|
| Rate for Payer: Cofinity Commercial |
$64.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.59
|
| Rate for Payer: Healthscope Commercial |
$53.51
|
| Rate for Payer: Healthscope Whirlpool |
$53.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.82
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.05
|
| Rate for Payer: Nomi Health Commercial |
$53.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: PACE SWMI |
$44.59
|
| Rate for Payer: PHP Medicare Advantage |
$44.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.49
|
| Rate for Payer: Priority Health Medicare |
$44.59
|
| Rate for Payer: Priority Health Narrow Network |
$88.49
|
| Rate for Payer: Railroad Medicare Medicare |
$44.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.59
|
| Rate for Payer: UHC Exchange |
$92.57
|
| Rate for Payer: UHC Medicaid |
$28.76
|
| Rate for Payer: UHCCP DNSP |
$44.59
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
|
|
PR NJX DX/THER SBST EPIDURAL/SUBARACH LUMBAR/SACRAL
|
Professional
|
Both
|
$781.00
|
|
|
Service Code
|
HCPCS 62311
|
| Min. Negotiated Rate |
$312.40 |
| Max. Negotiated Rate |
$585.75 |
| Rate for Payer: BCBS Complete |
$312.40
|
| Rate for Payer: Cash Price |
$624.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$585.75
|
|
|
PR NJX DX/THER SBST EPIDURAL/SUBRACH CERV/THORACIC
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 62310
|
| Min. Negotiated Rate |
$277.60 |
| Max. Negotiated Rate |
$520.50 |
| Rate for Payer: BCBS Complete |
$277.60
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.50
|
|
|
PR NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 62321
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna Commercial |
$126.01
|
| Rate for Payer: Aetna Medicare |
$94.04
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$94.04
|
| Rate for Payer: BCN Commercial |
$159.85
|
| Rate for Payer: BCN Medicare Advantage |
$94.04
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cofinity Commercial |
$126.01
|
| Rate for Payer: Cofinity Commercial |
$135.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.04
|
| Rate for Payer: Healthscope Commercial |
$112.85
|
| Rate for Payer: Healthscope Whirlpool |
$112.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.74
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.44
|
| Rate for Payer: Nomi Health Commercial |
$112.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.00
|
| Rate for Payer: PACE SWMI |
$94.04
|
| Rate for Payer: PHP Medicare Advantage |
$94.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$185.66
|
| Rate for Payer: Priority Health Medicare |
$94.04
|
| Rate for Payer: Priority Health Narrow Network |
$185.66
|
| Rate for Payer: Railroad Medicare Medicare |
$94.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.04
|
| Rate for Payer: UHC Exchange |
$188.91
|
| Rate for Payer: UHC Medicaid |
$60.92
|
| Rate for Payer: UHCCP DNSP |
$94.04
|
| Rate for Payer: UHCCP Medicaid |
$60.92
|
|
