|
PR NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 20560
|
| Min. Negotiated Rate |
$20.70 |
| Max. Negotiated Rate |
$37.63 |
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$37.63
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.40
|
| Rate for Payer: Priority Health Narrow Network |
$22.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.70
|
| Rate for Payer: UHC Exchange |
$20.70
|
|
|
PR NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 20561
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$54.73 |
| Rate for Payer: Aetna Commercial |
$32.61
|
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$54.73
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.59
|
| Rate for Payer: Priority Health Narrow Network |
$33.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.30
|
| Rate for Payer: UHC Exchange |
$31.30
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME <= 50 SQ CM
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS 97605
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$796.68 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: Aetna Medicare |
$49.00
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS Trust/PPO |
$796.68
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.51
|
| Rate for Payer: Priority Health Narrow Network |
$34.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.00
|
| Rate for Payer: UHC Exchange |
$28.00
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 97606
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$1,160.68 |
| Rate for Payer: Aetna Commercial |
$30.62
|
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.68
|
| Rate for Payer: BCN Commercial |
$74.28
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.30
|
| Rate for Payer: Priority Health Narrow Network |
$37.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.59
|
| Rate for Payer: UHC Exchange |
$30.59
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME <= 50 SQ CM
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 97607
|
| Min. Negotiated Rate |
$13.42 |
| Max. Negotiated Rate |
$768.68 |
| Rate for Payer: Aetna Commercial |
$25.52
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS Trust/PPO |
$768.68
|
| Rate for Payer: BCN Commercial |
$535.59
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.82
|
| Rate for Payer: Priority Health Narrow Network |
$35.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.82
|
| Rate for Payer: UHC Exchange |
$186.82
|
| Rate for Payer: UHCCP Medicaid |
$13.42
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 97608
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$1,073.51 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.51
|
| Rate for Payer: BCN Commercial |
$537.55
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.48
|
| Rate for Payer: Priority Health Narrow Network |
$39.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.82
|
| Rate for Payer: UHC Exchange |
$186.82
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
|
|
PR NEPHRECTOMY PARTIAL
|
Professional
|
Both
|
$2,530.00
|
|
|
Service Code
|
HCPCS 50240
|
| Min. Negotiated Rate |
$846.89 |
| Max. Negotiated Rate |
$3,703.38 |
| Rate for Payer: Aetna Commercial |
$1,700.84
|
| Rate for Payer: Aetna Medicare |
$1,265.00
|
| Rate for Payer: BCBS Complete |
$889.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,703.38
|
| Rate for Payer: BCN Commercial |
$1,906.82
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Meridian Medicaid |
$889.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,644.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,105.36
|
| Rate for Payer: Priority Health Narrow Network |
$2,105.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,598.66
|
| Rate for Payer: UHC Exchange |
$1,598.66
|
| Rate for Payer: UHCCP Medicaid |
$846.89
|
|
|
PR NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN
|
Professional
|
Both
|
$2,808.00
|
|
|
Service Code
|
HCPCS 50236
|
| Min. Negotiated Rate |
$931.02 |
| Max. Negotiated Rate |
$5,250.25 |
| Rate for Payer: Aetna Commercial |
$1,881.80
|
| Rate for Payer: Aetna Medicare |
$1,404.00
|
| Rate for Payer: BCBS Complete |
$977.57
|
| Rate for Payer: BCBS Trust/PPO |
$5,250.25
|
| Rate for Payer: BCN Commercial |
$2,103.27
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Meridian Medicaid |
$977.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,825.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,315.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,315.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,774.40
|
| Rate for Payer: UHC Exchange |
$1,774.40
|
| Rate for Payer: UHCCP Medicaid |
$931.02
|
|
|
PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ
|
Professional
|
Both
|
$3,705.00
|
|
|
Service Code
|
HCPCS 50220
|
| Min. Negotiated Rate |
$676.28 |
| Max. Negotiated Rate |
$4,223.76 |
| Rate for Payer: Aetna Commercial |
$1,352.45
|
| Rate for Payer: Aetna Medicare |
$1,852.50
|
| Rate for Payer: BCBS Complete |
$710.09
|
| Rate for Payer: BCBS Trust/PPO |
$4,223.76
|
| Rate for Payer: BCN Commercial |
$1,521.26
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Meridian Medicaid |
$710.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,672.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,672.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,245.61
|
| Rate for Payer: UHC Exchange |
$1,245.61
|
| Rate for Payer: UHCCP Medicaid |
$676.28
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD
|
Professional
|
Both
|
$4,384.00
|
|
|
Service Code
|
HCPCS 50230
|
| Min. Negotiated Rate |
$814.51 |
| Max. Negotiated Rate |
$3,770.48 |
| Rate for Payer: Aetna Commercial |
$1,645.84
|
| Rate for Payer: Aetna Medicare |
$2,192.00
|
| Rate for Payer: BCBS Complete |
$855.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,770.48
|
| Rate for Payer: BCN Commercial |
$1,839.87
|
| Rate for Payer: Cash Price |
$3,507.20
|
| Rate for Payer: Cash Price |
$3,507.20
|
| Rate for Payer: Meridian Medicaid |
$855.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$814.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,849.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,024.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,024.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,549.18
|
| Rate for Payer: UHC Exchange |
$1,549.18
|
| Rate for Payer: UHCCP Medicaid |
$814.51
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL
|
Professional
|
Both
|
$3,454.00
|
|
|
Service Code
|
HCPCS 50225
|
| Min. Negotiated Rate |
$755.72 |
| Max. Negotiated Rate |
$3,687.01 |
| Rate for Payer: Aetna Commercial |
$1,542.79
|
| Rate for Payer: Aetna Medicare |
$1,727.00
|
| Rate for Payer: BCBS Complete |
$793.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,687.01
|
| Rate for Payer: BCN Commercial |
$1,734.81
|
| Rate for Payer: Cash Price |
$2,763.20
|
| Rate for Payer: Cash Price |
$2,763.20
|
| Rate for Payer: Meridian Medicaid |
$793.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$755.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,245.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,921.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,921.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,436.07
|
| Rate for Payer: UHC Exchange |
$1,436.07
|
| Rate for Payer: UHCCP Medicaid |
$755.72
|
|
|
PR NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC
|
Professional
|
Both
|
$2,488.00
|
|
|
Service Code
|
HCPCS 50234
|
| Min. Negotiated Rate |
$828.78 |
| Max. Negotiated Rate |
$4,336.29 |
| Rate for Payer: Aetna Commercial |
$1,674.08
|
| Rate for Payer: Aetna Medicare |
$1,244.00
|
| Rate for Payer: BCBS Complete |
$870.22
|
| Rate for Payer: BCBS Trust/PPO |
$4,336.29
|
| Rate for Payer: BCN Commercial |
$1,874.08
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Meridian Medicaid |
$870.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$828.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,058.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,058.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,571.53
|
| Rate for Payer: UHC Exchange |
$1,571.53
|
| Rate for Payer: UHCCP Medicaid |
$828.78
|
|
|
PR NEPHROLITHOTOMY REMOVAL CALCULUS
|
Professional
|
Both
|
$2,064.00
|
|
|
Service Code
|
HCPCS 50060
|
| Min. Negotiated Rate |
$725.69 |
| Max. Negotiated Rate |
$2,591.84 |
| Rate for Payer: Aetna Commercial |
$1,462.76
|
| Rate for Payer: Aetna Medicare |
$1,032.00
|
| Rate for Payer: BCBS Complete |
$761.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,591.84
|
| Rate for Payer: BCN Commercial |
$1,636.58
|
| Rate for Payer: Cash Price |
$1,651.20
|
| Rate for Payer: Cash Price |
$1,651.20
|
| Rate for Payer: Meridian Medicaid |
$761.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,341.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,804.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,804.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,377.71
|
| Rate for Payer: UHC Exchange |
$1,377.71
|
| Rate for Payer: UHCCP Medicaid |
$725.69
|
|
|
PR NEPHROLITHOTOMY RMVL LARGE STAGHORN CALCULUS
|
Professional
|
Both
|
$3,414.00
|
|
|
Service Code
|
HCPCS 50075
|
| Min. Negotiated Rate |
$926.55 |
| Max. Negotiated Rate |
$2,775.16 |
| Rate for Payer: Aetna Commercial |
$1,870.27
|
| Rate for Payer: Aetna Medicare |
$1,707.00
|
| Rate for Payer: BCBS Complete |
$972.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,775.16
|
| Rate for Payer: BCN Commercial |
$2,090.56
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Meridian Medicaid |
$972.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,219.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,303.49
|
| Rate for Payer: Priority Health Narrow Network |
$2,303.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,768.07
|
| Rate for Payer: UHC Exchange |
$1,768.07
|
| Rate for Payer: UHCCP Medicaid |
$926.55
|
|
|
PR NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY
|
Professional
|
Both
|
$2,305.00
|
|
|
Service Code
|
HCPCS 50500
|
| Min. Negotiated Rate |
$828.57 |
| Max. Negotiated Rate |
$2,060.62 |
| Rate for Payer: Aetna Commercial |
$1,602.20
|
| Rate for Payer: Aetna Medicare |
$1,152.50
|
| Rate for Payer: BCBS Complete |
$870.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.58
|
| Rate for Payer: BCN Commercial |
$1,819.35
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Meridian Medicaid |
$870.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$828.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,498.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,060.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,060.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,443.07
|
| Rate for Payer: UHC Exchange |
$1,443.07
|
| Rate for Payer: UHCCP Medicaid |
$828.57
|
|
|
PR NEPHROSTOMY NEPHROTOMY W/DRAINAGE
|
Professional
|
Both
|
$1,765.00
|
|
|
Service Code
|
HCPCS 50040
|
| Min. Negotiated Rate |
$591.71 |
| Max. Negotiated Rate |
$3,134.93 |
| Rate for Payer: Aetna Commercial |
$1,185.26
|
| Rate for Payer: Aetna Medicare |
$882.50
|
| Rate for Payer: BCBS Complete |
$621.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,134.93
|
| Rate for Payer: BCN Commercial |
$1,332.14
|
| Rate for Payer: Cash Price |
$1,412.00
|
| Rate for Payer: Cash Price |
$1,412.00
|
| Rate for Payer: Meridian Medicaid |
$621.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,469.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,469.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.05
|
| Rate for Payer: UHC Exchange |
$1,115.05
|
| Rate for Payer: UHCCP Medicaid |
$591.71
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 95912
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$8,557.53 |
| Rate for Payer: Aetna Commercial |
$283.19
|
| Rate for Payer: Aetna Commercial |
$283.19
|
| Rate for Payer: Aetna Medicare |
$159.50
|
| Rate for Payer: Aetna Medicare |
$266.00
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: BCN Commercial |
$360.16
|
| Rate for Payer: BCN Commercial |
$360.16
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.52
|
| Rate for Payer: Priority Health Narrow Network |
$208.52
|
| Rate for Payer: Priority Health Narrow Network |
$208.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.92
|
| Rate for Payer: UHC Exchange |
$290.92
|
| Rate for Payer: UHC Exchange |
$290.92
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
|
|
PR NERVE CONDUCTION STUDIES 1-2 STUDIES
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 95907
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$1,173.88 |
| Rate for Payer: Aetna Commercial |
$102.58
|
| Rate for Payer: Aetna Commercial |
$102.58
|
| Rate for Payer: Aetna Medicare |
$85.00
|
| Rate for Payer: Aetna Medicare |
$45.50
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.88
|
| Rate for Payer: BCN Commercial |
$130.48
|
| Rate for Payer: BCN Commercial |
$130.48
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.11
|
| Rate for Payer: Priority Health Narrow Network |
$70.11
|
| Rate for Payer: Priority Health Narrow Network |
$70.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.29
|
| Rate for Payer: UHC Exchange |
$105.29
|
| Rate for Payer: UHC Exchange |
$105.29
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
|
|
PR NERVE CONDUCTION STUDIES 13/> STUDIES
|
Professional
|
Both
|
$534.00
|
|
|
Service Code
|
HCPCS 95913
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$415.86 |
| Rate for Payer: Aetna Commercial |
$328.98
|
| Rate for Payer: Aetna Commercial |
$328.98
|
| Rate for Payer: Aetna Medicare |
$267.00
|
| Rate for Payer: Aetna Medicare |
$438.50
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS Trust/PPO |
$214.87
|
| Rate for Payer: BCBS Trust/PPO |
$214.87
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.51
|
| Rate for Payer: Priority Health Narrow Network |
$246.51
|
| Rate for Payer: Priority Health Narrow Network |
$246.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$337.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$337.33
|
| Rate for Payer: UHC Exchange |
$337.33
|
| Rate for Payer: UHC Exchange |
$337.33
|
| Rate for Payer: UHCCP Medicaid |
$116.72
|
| Rate for Payer: UHCCP Medicaid |
$116.72
|
|
|
PR NERVE CONDUCTION STUDIES 3-4 STUDIES
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 95908
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$1,235.69 |
| Rate for Payer: Aetna Commercial |
$129.47
|
| Rate for Payer: Aetna Commercial |
$129.47
|
| Rate for Payer: Aetna Medicare |
$109.00
|
| Rate for Payer: Aetna Medicare |
$169.50
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.69
|
| Rate for Payer: BCN Commercial |
$162.25
|
| Rate for Payer: BCN Commercial |
$162.25
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.75
|
| Rate for Payer: Priority Health Narrow Network |
$87.75
|
| Rate for Payer: Priority Health Narrow Network |
$87.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.92
|
| Rate for Payer: UHC Exchange |
$129.92
|
| Rate for Payer: UHC Exchange |
$129.92
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
|
|
PR NERVE CONDUCTION STUDIES 5-6 STUDIES
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 95909
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$1,003.24 |
| Rate for Payer: Aetna Commercial |
$154.55
|
| Rate for Payer: Aetna Commercial |
$154.55
|
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: Aetna Medicare |
$203.00
|
| Rate for Payer: BCBS Complete |
$51.89
|
| Rate for Payer: BCBS Complete |
$51.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.24
|
| Rate for Payer: BCN Commercial |
$194.98
|
| Rate for Payer: BCN Commercial |
$194.98
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Meridian Medicaid |
$51.89
|
| Rate for Payer: Meridian Medicaid |
$51.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.94
|
| Rate for Payer: Priority Health Narrow Network |
$104.94
|
| Rate for Payer: Priority Health Narrow Network |
$104.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.70
|
| Rate for Payer: UHC Exchange |
$155.70
|
| Rate for Payer: UHC Exchange |
$155.70
|
| Rate for Payer: UHCCP Medicaid |
$49.42
|
| Rate for Payer: UHCCP Medicaid |
$49.42
|
|
|
PR NERVE CONDUCTION STUDIES 7-8 STUDIES
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 95910
|
| Min. Negotiated Rate |
$65.82 |
| Max. Negotiated Rate |
$1,982.71 |
| Rate for Payer: Aetna Commercial |
$203.39
|
| Rate for Payer: Aetna Commercial |
$203.39
|
| Rate for Payer: Aetna Medicare |
$190.50
|
| Rate for Payer: Aetna Medicare |
$267.00
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCN Commercial |
$255.09
|
| Rate for Payer: BCN Commercial |
$255.09
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.77
|
| Rate for Payer: Priority Health Narrow Network |
$139.77
|
| Rate for Payer: Priority Health Narrow Network |
$139.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$205.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$205.00
|
| Rate for Payer: UHC Exchange |
$205.00
|
| Rate for Payer: UHC Exchange |
$205.00
|
| Rate for Payer: UHCCP Medicaid |
$65.82
|
| Rate for Payer: UHCCP Medicaid |
$65.82
|
|
|
PR NERVE CONDUCTION STUDIES 9-10 STUDIES
|
Professional
|
Both
|
$453.00
|
|
|
Service Code
|
HCPCS 95911
|
| Min. Negotiated Rate |
$82.22 |
| Max. Negotiated Rate |
$640.30 |
| Rate for Payer: Aetna Commercial |
$244.32
|
| Rate for Payer: Aetna Commercial |
$244.32
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Aetna Medicare |
$226.50
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.59
|
| Rate for Payer: Priority Health Narrow Network |
$174.59
|
| Rate for Payer: Priority Health Narrow Network |
$174.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.34
|
| Rate for Payer: UHC Exchange |
$248.34
|
| Rate for Payer: UHC Exchange |
$248.34
|
| Rate for Payer: UHCCP Medicaid |
$82.22
|
| Rate for Payer: UHCCP Medicaid |
$82.22
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG <4 CM
|
Professional
|
Both
|
$2,147.00
|
|
|
Service Code
|
HCPCS 64892
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$1,797.71 |
| Rate for Payer: Aetna Commercial |
$1,351.70
|
| Rate for Payer: Aetna Medicare |
$1,073.50
|
| Rate for Payer: BCBS Complete |
$711.88
|
| Rate for Payer: BCBS Trust/PPO |
$214.49
|
| Rate for Payer: BCN Commercial |
$1,535.43
|
| Rate for Payer: Cash Price |
$1,717.60
|
| Rate for Payer: Cash Price |
$1,717.60
|
| Rate for Payer: Meridian Medicaid |
$711.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$677.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,797.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,797.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,220.36
|
| Rate for Payer: UHC Exchange |
$1,220.36
|
| Rate for Payer: UHCCP Medicaid |
$677.98
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG >4 CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 64893
|
| Min. Negotiated Rate |
$605.43 |
| Max. Negotiated Rate |
$1,916.01 |
| Rate for Payer: Aetna Commercial |
$1,442.60
|
| Rate for Payer: Aetna Medicare |
$867.00
|
| Rate for Payer: BCBS Complete |
$759.07
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: BCN Commercial |
$1,636.09
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Meridian Medicaid |
$759.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$722.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,916.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,916.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,290.85
|
| Rate for Payer: UHC Exchange |
$1,290.85
|
| Rate for Payer: UHCCP Medicaid |
$722.92
|
|
