|
PR NASOPHARYNGOSCOPY W/ENDOSCOPE SPX
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 92511
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$552.07 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: Aetna Medicare |
$115.50
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCBS Trust/PPO |
$552.07
|
| Rate for Payer: BCN Commercial |
$139.00
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.10
|
| Rate for Payer: Priority Health Narrow Network |
$51.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.97
|
| Rate for Payer: UHC Exchange |
$60.97
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
|
|
PR NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 95860
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$1,210.86 |
| Rate for Payer: Aetna Commercial |
$127.72
|
| Rate for Payer: Aetna Medicare |
$107.50
|
| Rate for Payer: BCBS Complete |
$33.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,210.86
|
| Rate for Payer: BCN Commercial |
$163.71
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Meridian Medicaid |
$33.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.40
|
| Rate for Payer: Priority Health Narrow Network |
$67.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.85
|
| Rate for Payer: UHC Exchange |
$86.85
|
| Rate for Payer: UHCCP Medicaid |
$31.74
|
|
|
PR NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$296.00
|
|
|
Service Code
|
HCPCS 95861
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$1,443.84 |
| Rate for Payer: Aetna Commercial |
$184.98
|
| Rate for Payer: Aetna Medicare |
$148.00
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,443.84
|
| Rate for Payer: BCN Commercial |
$234.08
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.64
|
| Rate for Payer: Priority Health Narrow Network |
$107.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.53
|
| Rate for Payer: UHC Exchange |
$126.53
|
| Rate for Payer: UHCCP Medicaid |
$50.48
|
|
|
PR NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS 95863
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$706.87 |
| Rate for Payer: Aetna Commercial |
$240.60
|
| Rate for Payer: Aetna Medicare |
$180.50
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS Trust/PPO |
$706.87
|
| Rate for Payer: BCN Commercial |
$303.96
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.17
|
| Rate for Payer: Priority Health Narrow Network |
$131.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$151.64
|
| Rate for Payer: UHC Exchange |
$151.64
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
|
|
PR NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$413.00
|
|
|
Service Code
|
HCPCS 95864
|
| Min. Negotiated Rate |
$65.60 |
| Max. Negotiated Rate |
$953.58 |
| Rate for Payer: Aetna Commercial |
$268.89
|
| Rate for Payer: Aetna Medicare |
$206.50
|
| Rate for Payer: BCBS Complete |
$68.88
|
| Rate for Payer: BCBS Trust/PPO |
$953.58
|
| Rate for Payer: BCN Commercial |
$340.61
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Meridian Medicaid |
$68.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.77
|
| Rate for Payer: Priority Health Narrow Network |
$139.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.69
|
| Rate for Payer: UHC Exchange |
$169.69
|
| Rate for Payer: UHCCP Medicaid |
$65.60
|
|
|
PR NDL OCULOELECTROMYOGRAPHY 1+EO MUSC 1/BOTH EYE
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 92265
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$1,168.07 |
| Rate for Payer: Aetna Commercial |
$91.63
|
| Rate for Payer: Aetna Medicare |
$37.00
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.07
|
| Rate for Payer: BCN Commercial |
$126.08
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.65
|
| Rate for Payer: Priority Health Narrow Network |
$55.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.77
|
| Rate for Payer: UHC Exchange |
$79.77
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
|
|
PR NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 44385
|
| Min. Negotiated Rate |
$46.22 |
| Max. Negotiated Rate |
$1,990.63 |
| Rate for Payer: Aetna Commercial |
$95.20
|
| Rate for Payer: Aetna Medicare |
$436.50
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,990.63
|
| Rate for Payer: BCN Commercial |
$317.65
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.45
|
| Rate for Payer: Priority Health Narrow Network |
$129.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.84
|
| Rate for Payer: UHC Exchange |
$132.84
|
| Rate for Payer: UHCCP Medicaid |
$46.22
|
|
|
PR NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 44386
|
| Min. Negotiated Rate |
$56.45 |
| Max. Negotiated Rate |
$3,257.50 |
| Rate for Payer: Aetna Commercial |
$117.55
|
| Rate for Payer: Aetna Medicare |
$519.00
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,257.50
|
| Rate for Payer: BCN Commercial |
$458.38
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Meridian Medicaid |
$59.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.09
|
| Rate for Payer: Priority Health Narrow Network |
$158.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.25
|
| Rate for Payer: UHC Exchange |
$156.25
|
| Rate for Payer: UHCCP Medicaid |
$56.45
|
|
|
PR NDSC NJX IMPLT MATRL URT&/BLDR NCK
|
Professional
|
Both
|
$1,749.00
|
|
|
Service Code
|
HCPCS 51715
|
| Min. Negotiated Rate |
$126.74 |
| Max. Negotiated Rate |
$2,071.46 |
| Rate for Payer: Aetna Commercial |
$257.04
|
| Rate for Payer: Aetna Medicare |
$874.50
|
| Rate for Payer: BCBS Complete |
$133.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,071.46
|
| Rate for Payer: BCN Commercial |
$544.39
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Meridian Medicaid |
$133.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.30
|
| Rate for Payer: Priority Health Narrow Network |
$315.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$240.42
|
| Rate for Payer: UHC Exchange |
$240.42
|
| Rate for Payer: UHCCP Medicaid |
$126.74
|
|
|
PR NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 33508
|
| Min. Negotiated Rate |
$10.01 |
| Max. Negotiated Rate |
$878.56 |
| Rate for Payer: Aetna Commercial |
$21.23
|
| Rate for Payer: Aetna Medicare |
$171.00
|
| Rate for Payer: BCBS Complete |
$10.51
|
| Rate for Payer: BCBS Trust/PPO |
$878.56
|
| Rate for Payer: BCN Commercial |
$22.97
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Meridian Medicaid |
$10.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.00
|
| Rate for Payer: Priority Health Narrow Network |
$25.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.21
|
| Rate for Payer: UHC Exchange |
$21.21
|
| Rate for Payer: UHCCP Medicaid |
$10.01
|
|
|
PR NDSC URETEROTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 50980
|
| Min. Negotiated Rate |
$224.50 |
| Max. Negotiated Rate |
$2,962.71 |
| Rate for Payer: Aetna Commercial |
$455.66
|
| Rate for Payer: Aetna Medicare |
$345.50
|
| Rate for Payer: BCBS Complete |
$235.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,962.71
|
| Rate for Payer: BCN Commercial |
$507.73
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Meridian Medicaid |
$235.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$558.16
|
| Rate for Payer: Priority Health Narrow Network |
$558.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$435.28
|
| Rate for Payer: UHC Exchange |
$435.28
|
| Rate for Payer: UHCCP Medicaid |
$224.50
|
|
|
PR NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 50972
|
| Min. Negotiated Rate |
$225.99 |
| Max. Negotiated Rate |
$2,720.22 |
| Rate for Payer: Aetna Commercial |
$457.88
|
| Rate for Payer: Aetna Medicare |
$346.50
|
| Rate for Payer: BCBS Complete |
$237.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,720.22
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Meridian Medicaid |
$237.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.83
|
| Rate for Payer: Priority Health Narrow Network |
$560.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$437.02
|
| Rate for Payer: UHC Exchange |
$437.02
|
| Rate for Payer: UHCCP Medicaid |
$225.99
|
|
|
PR NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29848
|
| Min. Negotiated Rate |
$337.61 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$677.64
|
| Rate for Payer: Aetna Medicare |
$938.50
|
| Rate for Payer: BCBS Complete |
$354.49
|
| Rate for Payer: BCBS Trust/PPO |
$571.09
|
| Rate for Payer: BCN Commercial |
$756.47
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Meridian Medicaid |
$354.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$797.90
|
| Rate for Payer: Priority Health Narrow Network |
$797.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$568.70
|
| Rate for Payer: UHC Exchange |
$568.70
|
| Rate for Payer: UHCCP Medicaid |
$337.61
|
|
|
PR NECK LIFT
|
Professional
|
Both
|
$2,040.00
|
|
|
Service Code
|
HCPCS 00541
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$816.00 |
| Max. Negotiated Rate |
$1,326.00 |
| Rate for Payer: Aetna Medicare |
$1,020.00
|
| Rate for Payer: BCBS Complete |
$816.00
|
| Rate for Payer: Cash Price |
$1,632.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.00
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 95868
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$284.75 |
| Rate for Payer: Aetna Commercial |
$157.00
|
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS Trust/PPO |
$284.75
|
| Rate for Payer: BCN Commercial |
$203.29
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.78
|
| Rate for Payer: Priority Health Narrow Network |
$82.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.35
|
| Rate for Payer: UHC Exchange |
$104.35
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
HCPCS 95867
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$620.75 |
| Rate for Payer: Aetna Commercial |
$120.01
|
| Rate for Payer: Aetna Medicare |
$97.50
|
| Rate for Payer: BCBS Complete |
$27.51
|
| Rate for Payer: BCBS Trust/PPO |
$620.75
|
| Rate for Payer: BCN Commercial |
$156.38
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Meridian Medicaid |
$27.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.18
|
| Rate for Payer: Priority Health Narrow Network |
$55.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.17
|
| Rate for Payer: UHC Exchange |
$76.17
|
| Rate for Payer: UHCCP Medicaid |
$26.20
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 95866
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$665.13 |
| Rate for Payer: Aetna Commercial |
$146.53
|
| Rate for Payer: Aetna Medicare |
$118.50
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS Trust/PPO |
$665.13
|
| Rate for Payer: BCN Commercial |
$184.72
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.12
|
| Rate for Payer: Priority Health Narrow Network |
$84.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.40
|
| Rate for Payer: UHC Exchange |
$100.40
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
|
|
PR NEEDLE ELECTROMYOGRAPHY LARYNX
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 95865
|
| Min. Negotiated Rate |
$51.33 |
| Max. Negotiated Rate |
$990.03 |
| Rate for Payer: Aetna Commercial |
$168.68
|
| Rate for Payer: Aetna Medicare |
$186.00
|
| Rate for Payer: BCBS Complete |
$53.90
|
| Rate for Payer: BCBS Trust/PPO |
$990.03
|
| Rate for Payer: BCN Commercial |
$217.95
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Meridian Medicaid |
$53.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.47
|
| Rate for Payer: Priority Health Narrow Network |
$109.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.70
|
| Rate for Payer: UHC Exchange |
$118.70
|
| Rate for Payer: UHCCP Medicaid |
$51.33
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 95885
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$1,360.37 |
| Rate for Payer: Aetna Commercial |
$70.67
|
| Rate for Payer: Aetna Commercial |
$70.67
|
| Rate for Payer: Aetna Medicare |
$32.00
|
| Rate for Payer: Aetna Medicare |
$77.00
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.37
|
| Rate for Payer: BCN Commercial |
$90.41
|
| Rate for Payer: BCN Commercial |
$90.41
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.43
|
| Rate for Payer: Priority Health Narrow Network |
$24.43
|
| Rate for Payer: Priority Health Narrow Network |
$24.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.69
|
| Rate for Payer: UHC Exchange |
$61.69
|
| Rate for Payer: UHC Exchange |
$61.69
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 95886
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$1,755.54 |
| Rate for Payer: Aetna Commercial |
$109.55
|
| Rate for Payer: Aetna Commercial |
$109.55
|
| Rate for Payer: Aetna Medicare |
$121.00
|
| Rate for Payer: Aetna Medicare |
$85.00
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.54
|
| Rate for Payer: BCN Commercial |
$142.21
|
| Rate for Payer: BCN Commercial |
$142.21
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.22
|
| Rate for Payer: Priority Health Narrow Network |
$67.22
|
| Rate for Payer: Priority Health Narrow Network |
$67.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.26
|
| Rate for Payer: UHC Exchange |
$97.26
|
| Rate for Payer: UHC Exchange |
$97.26
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 95874
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$1,247.84 |
| Rate for Payer: Aetna Commercial |
$87.83
|
| Rate for Payer: Aetna Medicare |
$63.00
|
| Rate for Payer: BCBS Complete |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.84
|
| Rate for Payer: BCN Commercial |
$112.89
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Meridian Medicaid |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.78
|
| Rate for Payer: Priority Health Narrow Network |
$25.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.43
|
| Rate for Payer: UHC Exchange |
$49.43
|
| Rate for Payer: UHCCP Medicaid |
$12.14
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 95870
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$288.98 |
| Rate for Payer: Aetna Commercial |
$96.78
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCBS Complete |
$12.97
|
| Rate for Payer: BCBS Trust/PPO |
$288.98
|
| Rate for Payer: BCN Commercial |
$121.68
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Meridian Medicaid |
$12.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.24
|
| Rate for Payer: Priority Health Narrow Network |
$26.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.55
|
| Rate for Payer: UHC Exchange |
$50.55
|
| Rate for Payer: UHCCP Medicaid |
$12.35
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 95887
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$1,456.52 |
| Rate for Payer: Aetna Commercial |
$94.79
|
| Rate for Payer: Aetna Commercial |
$94.79
|
| Rate for Payer: Aetna Medicare |
$136.00
|
| Rate for Payer: Aetna Medicare |
$67.00
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.52
|
| Rate for Payer: BCN Commercial |
$122.17
|
| Rate for Payer: BCN Commercial |
$122.17
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.85
|
| Rate for Payer: Priority Health Narrow Network |
$48.85
|
| Rate for Payer: Priority Health Narrow Network |
$48.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.51
|
| Rate for Payer: UHC Exchange |
$86.51
|
| Rate for Payer: UHC Exchange |
$86.51
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 95869
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$296.90 |
| Rate for Payer: Aetna Commercial |
$108.17
|
| Rate for Payer: Aetna Medicare |
$73.00
|
| Rate for Payer: BCBS Complete |
$12.97
|
| Rate for Payer: BCBS Trust/PPO |
$296.90
|
| Rate for Payer: BCN Commercial |
$140.25
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Meridian Medicaid |
$12.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.24
|
| Rate for Payer: Priority Health Narrow Network |
$26.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.04
|
| Rate for Payer: UHC Exchange |
$52.04
|
| Rate for Payer: UHCCP Medicaid |
$12.35
|
|
|
PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
HCPCS 95872
|
| Min. Negotiated Rate |
$92.66 |
| Max. Negotiated Rate |
$411.55 |
| Rate for Payer: Aetna Commercial |
$224.41
|
| Rate for Payer: Aetna Medicare |
$162.00
|
| Rate for Payer: BCBS Complete |
$97.29
|
| Rate for Payer: BCBS Trust/PPO |
$411.55
|
| Rate for Payer: BCN Commercial |
$287.34
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Meridian Medicaid |
$97.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.20
|
| Rate for Payer: Priority Health Narrow Network |
$197.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.34
|
| Rate for Payer: UHC Exchange |
$179.34
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
|
