|
PR PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,404.00
|
|
|
Service Code
|
HCPCS 26235
|
| Min. Negotiated Rate |
$296.28 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Aetna Commercial |
$603.94
|
| Rate for Payer: Aetna Medicare |
$450.70
|
| Rate for Payer: BCBS Complete |
$311.09
|
| Rate for Payer: BCBS MAPPO |
$450.70
|
| Rate for Payer: BCN Commercial |
$759.43
|
| Rate for Payer: BCN Medicare Advantage |
$450.70
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cofinity Commercial |
$649.01
|
| Rate for Payer: Cofinity Commercial |
$603.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.70
|
| Rate for Payer: Healthscope Commercial |
$540.84
|
| Rate for Payer: Healthscope Whirlpool |
$540.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$473.24
|
| Rate for Payer: Meridian Medicaid |
$311.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$495.77
|
| Rate for Payer: Nomi Health Commercial |
$540.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.00
|
| Rate for Payer: PACE SWMI |
$450.70
|
| Rate for Payer: PHP Medicare Advantage |
$450.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$811.79
|
| Rate for Payer: Priority Health Medicare |
$450.70
|
| Rate for Payer: Priority Health Narrow Network |
$811.79
|
| Rate for Payer: Railroad Medicare Medicare |
$450.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$855.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$450.70
|
| Rate for Payer: UHC Exchange |
$855.71
|
| Rate for Payer: UHC Medicaid |
$296.28
|
| Rate for Payer: UHCCP DNSP |
$450.70
|
| Rate for Payer: UHCCP Medicaid |
$296.28
|
|
|
PR PARTIAL EXCISION SUPERFICIAL PELVIS
|
Professional
|
Both
|
$1,574.00
|
|
|
Service Code
|
HCPCS 27070
|
| Min. Negotiated Rate |
$526.75 |
| Max. Negotiated Rate |
$1,528.52 |
| Rate for Payer: Aetna Commercial |
$1,076.18
|
| Rate for Payer: Aetna Medicare |
$803.12
|
| Rate for Payer: BCBS Complete |
$553.09
|
| Rate for Payer: BCBS MAPPO |
$803.12
|
| Rate for Payer: BCN Commercial |
$1,326.12
|
| Rate for Payer: BCN Medicare Advantage |
$803.12
|
| Rate for Payer: Cash Price |
$1,259.20
|
| Rate for Payer: Cash Price |
$1,259.20
|
| Rate for Payer: Cofinity Commercial |
$1,156.49
|
| Rate for Payer: Cofinity Commercial |
$1,076.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$803.12
|
| Rate for Payer: Healthscope Commercial |
$963.74
|
| Rate for Payer: Healthscope Whirlpool |
$963.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$843.28
|
| Rate for Payer: Meridian Medicaid |
$553.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.43
|
| Rate for Payer: Nomi Health Commercial |
$963.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,180.50
|
| Rate for Payer: PACE SWMI |
$803.12
|
| Rate for Payer: PHP Medicare Advantage |
$803.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,417.59
|
| Rate for Payer: Priority Health Medicare |
$803.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,417.59
|
| Rate for Payer: Railroad Medicare Medicare |
$803.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,528.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$803.12
|
| Rate for Payer: UHC Exchange |
$1,528.52
|
| Rate for Payer: UHC Medicaid |
$526.75
|
| Rate for Payer: UHCCP DNSP |
$803.12
|
| Rate for Payer: UHCCP Medicaid |
$526.75
|
|
|
PR PARTIAL HYMENECTOMY OR REVISION HYMENAL RING
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 56700
|
| Min. Negotiated Rate |
$115.87 |
| Max. Negotiated Rate |
$507.75 |
| Rate for Payer: Aetna Commercial |
$237.73
|
| Rate for Payer: Aetna Medicare |
$177.41
|
| Rate for Payer: BCBS Complete |
$121.66
|
| Rate for Payer: BCBS MAPPO |
$177.41
|
| Rate for Payer: BCN Commercial |
$305.76
|
| Rate for Payer: BCN Medicare Advantage |
$177.41
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cofinity Commercial |
$255.47
|
| Rate for Payer: Cofinity Commercial |
$237.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.41
|
| Rate for Payer: Healthscope Commercial |
$212.89
|
| Rate for Payer: Healthscope Whirlpool |
$212.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.28
|
| Rate for Payer: Meridian Medicaid |
$121.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.15
|
| Rate for Payer: Nomi Health Commercial |
$212.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.75
|
| Rate for Payer: PACE SWMI |
$177.41
|
| Rate for Payer: PHP Medicare Advantage |
$177.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$309.67
|
| Rate for Payer: Priority Health Medicare |
$177.41
|
| Rate for Payer: Priority Health Narrow Network |
$309.67
|
| Rate for Payer: Railroad Medicare Medicare |
$177.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.41
|
| Rate for Payer: UHC Exchange |
$343.95
|
| Rate for Payer: UHC Medicaid |
$115.87
|
| Rate for Payer: UHCCP DNSP |
$177.41
|
| Rate for Payer: UHCCP Medicaid |
$115.87
|
|
|
PR PARTICAL EXCISION BONE PHALANX TOE
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 28124
|
| Min. Negotiated Rate |
$202.78 |
| Max. Negotiated Rate |
$705.75 |
| Rate for Payer: Aetna Commercial |
$412.56
|
| Rate for Payer: Aetna Medicare |
$307.88
|
| Rate for Payer: BCBS Complete |
$212.92
|
| Rate for Payer: BCBS MAPPO |
$307.88
|
| Rate for Payer: BCN Commercial |
$510.93
|
| Rate for Payer: BCN Medicare Advantage |
$307.88
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$443.35
|
| Rate for Payer: Cofinity Commercial |
$412.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.88
|
| Rate for Payer: Healthscope Commercial |
$369.46
|
| Rate for Payer: Healthscope Whirlpool |
$369.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.27
|
| Rate for Payer: Meridian Medicaid |
$212.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.67
|
| Rate for Payer: Nomi Health Commercial |
$369.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.75
|
| Rate for Payer: PACE SWMI |
$307.88
|
| Rate for Payer: PHP Medicare Advantage |
$307.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$546.18
|
| Rate for Payer: Priority Health Medicare |
$307.88
|
| Rate for Payer: Priority Health Narrow Network |
$546.18
|
| Rate for Payer: Railroad Medicare Medicare |
$307.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$577.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$307.88
|
| Rate for Payer: UHC Exchange |
$577.73
|
| Rate for Payer: UHC Medicaid |
$202.78
|
| Rate for Payer: UHCCP DNSP |
$307.88
|
| Rate for Payer: UHCCP Medicaid |
$202.78
|
|
|
PR PATELLECTOMY/HEMIPATELLECTOMY
|
Professional
|
Both
|
$2,164.00
|
|
|
Service Code
|
HCPCS 27350
|
| Min. Negotiated Rate |
$395.54 |
| Max. Negotiated Rate |
$1,623.00 |
| Rate for Payer: Aetna Commercial |
$808.72
|
| Rate for Payer: Aetna Medicare |
$603.52
|
| Rate for Payer: BCBS Complete |
$415.32
|
| Rate for Payer: BCBS MAPPO |
$603.52
|
| Rate for Payer: BCN Commercial |
$1,002.43
|
| Rate for Payer: BCN Medicare Advantage |
$603.52
|
| Rate for Payer: Cash Price |
$1,731.20
|
| Rate for Payer: Cash Price |
$1,731.20
|
| Rate for Payer: Cofinity Commercial |
$869.07
|
| Rate for Payer: Cofinity Commercial |
$808.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.52
|
| Rate for Payer: Healthscope Commercial |
$724.22
|
| Rate for Payer: Healthscope Whirlpool |
$724.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.70
|
| Rate for Payer: Meridian Medicaid |
$415.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$663.87
|
| Rate for Payer: Nomi Health Commercial |
$724.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.00
|
| Rate for Payer: PACE SWMI |
$603.52
|
| Rate for Payer: PHP Medicare Advantage |
$603.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,071.58
|
| Rate for Payer: Priority Health Medicare |
$603.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,071.58
|
| Rate for Payer: Railroad Medicare Medicare |
$603.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,137.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$603.52
|
| Rate for Payer: UHC Exchange |
$1,137.07
|
| Rate for Payer: UHC Medicaid |
$395.54
|
| Rate for Payer: UHCCP DNSP |
$603.52
|
| Rate for Payer: UHCCP Medicaid |
$395.54
|
|
|
PR PATIENT-INITIATED SPIROMETRIC RECORDING
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 94015
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$47.81 |
| Rate for Payer: Aetna Commercial |
$43.00
|
| Rate for Payer: Aetna Medicare |
$32.09
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$32.09
|
| Rate for Payer: BCN Commercial |
$47.81
|
| Rate for Payer: BCN Medicare Advantage |
$32.09
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$46.21
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.09
|
| Rate for Payer: Healthscope Commercial |
$38.51
|
| Rate for Payer: Healthscope Whirlpool |
$38.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.30
|
| Rate for Payer: Nomi Health Commercial |
$38.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PACE SWMI |
$32.09
|
| Rate for Payer: PHP Medicare Advantage |
$32.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$44.08
|
| Rate for Payer: Priority Health Medicare |
$32.09
|
| Rate for Payer: Priority Health Narrow Network |
$44.08
|
| Rate for Payer: Railroad Medicare Medicare |
$32.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.09
|
| Rate for Payer: UHC Exchange |
$45.77
|
| Rate for Payer: UHCCP DNSP |
$32.09
|
|
|
PR PCV13 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 90670
|
| Min. Negotiated Rate |
$224.25 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$257.99
|
| Rate for Payer: BCBS Trust/PPO |
$226.43
|
| Rate for Payer: BCN Commercial |
$270.00
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$224.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.99
|
| Rate for Payer: UHC Exchange |
$257.99
|
|
|
PR PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 90677
|
| Min. Negotiated Rate |
$298.49 |
| Max. Negotiated Rate |
$450.58 |
| Rate for Payer: Aetna Commercial |
$419.29
|
| Rate for Payer: Aetna Medicare |
$312.90
|
| Rate for Payer: BCBS MAPPO |
$312.90
|
| Rate for Payer: BCBS Trust/PPO |
$299.25
|
| Rate for Payer: BCN Commercial |
$350.00
|
| Rate for Payer: BCN Medicare Advantage |
$312.90
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$450.58
|
| Rate for Payer: Cofinity Commercial |
$419.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.90
|
| Rate for Payer: Healthscope Commercial |
$375.48
|
| Rate for Payer: Healthscope Whirlpool |
$375.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$344.19
|
| Rate for Payer: Nomi Health Commercial |
$375.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$305.25
|
| Rate for Payer: PACE SWMI |
$312.90
|
| Rate for Payer: PHP Medicare Advantage |
$312.90
|
| Rate for Payer: Priority Health Medicare |
$312.90
|
| Rate for Payer: Railroad Medicare Medicare |
$312.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$298.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.90
|
| Rate for Payer: UHC Exchange |
$298.49
|
| Rate for Payer: UHCCP DNSP |
$312.90
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 96573
|
| Min. Negotiated Rate |
$200.03 |
| Max. Negotiated Rate |
$327.67 |
| Rate for Payer: Aetna Commercial |
$268.04
|
| Rate for Payer: Aetna Medicare |
$200.03
|
| Rate for Payer: BCBS MAPPO |
$200.03
|
| Rate for Payer: BCN Commercial |
$327.67
|
| Rate for Payer: BCN Medicare Advantage |
$200.03
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Commercial |
$268.04
|
| Rate for Payer: Cofinity Commercial |
$288.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.03
|
| Rate for Payer: Healthscope Commercial |
$240.04
|
| Rate for Payer: Healthscope Whirlpool |
$240.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.03
|
| Rate for Payer: Nomi Health Commercial |
$240.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.00
|
| Rate for Payer: PACE SWMI |
$200.03
|
| Rate for Payer: PHP Medicare Advantage |
$200.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$302.18
|
| Rate for Payer: Priority Health Medicare |
$200.03
|
| Rate for Payer: Priority Health Narrow Network |
$302.18
|
| Rate for Payer: Railroad Medicare Medicare |
$200.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$200.03
|
| Rate for Payer: UHC Exchange |
$323.06
|
| Rate for Payer: UHCCP DNSP |
$200.03
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 96567
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$200.48 |
| Rate for Payer: Aetna Commercial |
$158.24
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: BCBS Complete |
$90.00
|
| Rate for Payer: BCBS MAPPO |
$118.09
|
| Rate for Payer: BCN Commercial |
$196.71
|
| Rate for Payer: BCN Medicare Advantage |
$118.09
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$170.05
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.09
|
| Rate for Payer: Healthscope Commercial |
$141.71
|
| Rate for Payer: Healthscope Whirlpool |
$141.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.90
|
| Rate for Payer: Nomi Health Commercial |
$141.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
| Rate for Payer: PACE SWMI |
$118.09
|
| Rate for Payer: PHP Medicare Advantage |
$118.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$181.40
|
| Rate for Payer: Priority Health Medicare |
$118.09
|
| Rate for Payer: Priority Health Narrow Network |
$181.40
|
| Rate for Payer: Railroad Medicare Medicare |
$118.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$200.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.09
|
| Rate for Payer: UHC Exchange |
$200.48
|
| Rate for Payer: UHCCP DNSP |
$118.09
|
|
|
PR PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR
|
Professional
|
Both
|
$1,337.00
|
|
|
Service Code
|
HCPCS 38770
|
| Min. Negotiated Rate |
$471.37 |
| Max. Negotiated Rate |
$1,606.81 |
| Rate for Payer: Aetna Commercial |
$980.02
|
| Rate for Payer: Aetna Medicare |
$731.36
|
| Rate for Payer: BCBS Complete |
$494.94
|
| Rate for Payer: BCBS MAPPO |
$731.36
|
| Rate for Payer: BCN Commercial |
$1,207.61
|
| Rate for Payer: BCN Medicare Advantage |
$731.36
|
| Rate for Payer: Cash Price |
$1,069.60
|
| Rate for Payer: Cash Price |
$1,069.60
|
| Rate for Payer: Cofinity Commercial |
$980.02
|
| Rate for Payer: Cofinity Commercial |
$1,053.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.36
|
| Rate for Payer: Healthscope Commercial |
$877.63
|
| Rate for Payer: Healthscope Whirlpool |
$877.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.93
|
| Rate for Payer: Meridian Medicaid |
$494.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$804.50
|
| Rate for Payer: Nomi Health Commercial |
$877.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.75
|
| Rate for Payer: PACE SWMI |
$731.36
|
| Rate for Payer: PHP Medicare Advantage |
$731.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,606.81
|
| Rate for Payer: Priority Health Medicare |
$731.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,606.81
|
| Rate for Payer: Railroad Medicare Medicare |
$731.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,419.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$731.36
|
| Rate for Payer: UHC Exchange |
$1,419.51
|
| Rate for Payer: UHC Medicaid |
$471.37
|
| Rate for Payer: UHCCP DNSP |
$731.36
|
| Rate for Payer: UHCCP Medicaid |
$471.37
|
|
|
PR PELVIC EXAMINATION
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 99459
|
| Min. Negotiated Rate |
$15.86 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$15.86
|
| Rate for Payer: BCBS MAPPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$31.87
|
| Rate for Payer: BCN Medicare Advantage |
$15.86
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$21.25
|
| Rate for Payer: Cofinity Commercial |
$22.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.86
|
| Rate for Payer: Healthscope Commercial |
$17.45
|
| Rate for Payer: Healthscope Whirlpool |
$17.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.45
|
| Rate for Payer: Nomi Health Commercial |
$19.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: PACE SWMI |
$15.86
|
| Rate for Payer: PHP Medicare Advantage |
$15.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$28.67
|
| Rate for Payer: Priority Health Medicare |
$15.86
|
| Rate for Payer: Priority Health Narrow Network |
$28.67
|
| Rate for Payer: Railroad Medicare Medicare |
$15.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.86
|
| Rate for Payer: UHC Exchange |
$31.88
|
| Rate for Payer: UHCCP DNSP |
$15.86
|
|
|
PR PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 57410
|
| Min. Negotiated Rate |
$61.56 |
| Max. Negotiated Rate |
$187.15 |
| Rate for Payer: Aetna Commercial |
$127.65
|
| Rate for Payer: Aetna Medicare |
$95.26
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCBS MAPPO |
$95.26
|
| Rate for Payer: BCN Commercial |
$158.86
|
| Rate for Payer: BCN Medicare Advantage |
$95.26
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$137.17
|
| Rate for Payer: Cofinity Commercial |
$127.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.26
|
| Rate for Payer: Healthscope Commercial |
$114.31
|
| Rate for Payer: Healthscope Whirlpool |
$114.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.02
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.79
|
| Rate for Payer: Nomi Health Commercial |
$114.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.50
|
| Rate for Payer: PACE SWMI |
$95.26
|
| Rate for Payer: PHP Medicare Advantage |
$95.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$160.89
|
| Rate for Payer: Priority Health Medicare |
$95.26
|
| Rate for Payer: Priority Health Narrow Network |
$160.89
|
| Rate for Payer: Railroad Medicare Medicare |
$95.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.26
|
| Rate for Payer: UHC Exchange |
$187.15
|
| Rate for Payer: UHC Medicaid |
$61.56
|
| Rate for Payer: UHCCP DNSP |
$95.26
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
|
|
PR PELVIC FIXATION OTHER THAN SACRUM
|
Professional
|
Both
|
$1,845.00
|
|
|
Service Code
|
HCPCS 22848
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$1,383.75 |
| Rate for Payer: Aetna Commercial |
$428.17
|
| Rate for Payer: Aetna Medicare |
$319.53
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$319.53
|
| Rate for Payer: BCN Commercial |
$590.28
|
| Rate for Payer: BCN Medicare Advantage |
$319.53
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cofinity Commercial |
$460.12
|
| Rate for Payer: Cofinity Commercial |
$428.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.53
|
| Rate for Payer: Healthscope Commercial |
$383.44
|
| Rate for Payer: Healthscope Whirlpool |
$383.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.51
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$351.48
|
| Rate for Payer: Nomi Health Commercial |
$383.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,383.75
|
| Rate for Payer: PACE SWMI |
$319.53
|
| Rate for Payer: PHP Medicare Advantage |
$319.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$574.38
|
| Rate for Payer: Priority Health Medicare |
$319.53
|
| Rate for Payer: Priority Health Narrow Network |
$574.38
|
| Rate for Payer: Railroad Medicare Medicare |
$319.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$641.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$319.53
|
| Rate for Payer: UHC Exchange |
$641.78
|
| Rate for Payer: UHC Medicaid |
$202.56
|
| Rate for Payer: UHCCP DNSP |
$319.53
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
|
|
PR PELVIC RING FRACTURE UNI/BIL
|
Professional
|
Both
|
$3,267.00
|
|
|
Service Code
|
HCPCS G0413
|
| Min. Negotiated Rate |
$623.66 |
| Max. Negotiated Rate |
$2,450.25 |
| Rate for Payer: Aetna Commercial |
$1,287.73
|
| Rate for Payer: Aetna Medicare |
$960.99
|
| Rate for Payer: BCBS Complete |
$654.84
|
| Rate for Payer: BCBS MAPPO |
$960.99
|
| Rate for Payer: BCN Commercial |
$1,611.97
|
| Rate for Payer: BCN Medicare Advantage |
$960.99
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cofinity Commercial |
$1,383.83
|
| Rate for Payer: Cofinity Commercial |
$1,287.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.99
|
| Rate for Payer: Healthscope Commercial |
$1,153.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,153.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,009.04
|
| Rate for Payer: Meridian Medicaid |
$654.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,057.09
|
| Rate for Payer: Nomi Health Commercial |
$1,153.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.25
|
| Rate for Payer: PACE SWMI |
$960.99
|
| Rate for Payer: PHP Medicare Advantage |
$960.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,723.15
|
| Rate for Payer: Priority Health Medicare |
$960.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,723.15
|
| Rate for Payer: Railroad Medicare Medicare |
$960.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,865.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$960.99
|
| Rate for Payer: UHC Exchange |
$1,865.33
|
| Rate for Payer: UHC Medicaid |
$623.66
|
| Rate for Payer: UHCCP DNSP |
$960.99
|
| Rate for Payer: UHCCP Medicaid |
$623.66
|
|
|
PR PELVIC RING FX TREAT INT FIX
|
Professional
|
Both
|
$3,228.00
|
|
|
Service Code
|
HCPCS G0414
|
| Min. Negotiated Rate |
$589.37 |
| Max. Negotiated Rate |
$2,421.00 |
| Rate for Payer: Aetna Commercial |
$1,215.69
|
| Rate for Payer: Aetna Medicare |
$907.23
|
| Rate for Payer: BCBS Complete |
$618.84
|
| Rate for Payer: BCBS MAPPO |
$907.23
|
| Rate for Payer: BCN Commercial |
$1,522.83
|
| Rate for Payer: BCN Medicare Advantage |
$907.23
|
| Rate for Payer: Cash Price |
$2,582.40
|
| Rate for Payer: Cash Price |
$2,582.40
|
| Rate for Payer: Cofinity Commercial |
$1,306.41
|
| Rate for Payer: Cofinity Commercial |
$1,215.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$907.23
|
| Rate for Payer: Healthscope Commercial |
$1,088.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$952.59
|
| Rate for Payer: Meridian Medicaid |
$618.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$997.95
|
| Rate for Payer: Nomi Health Commercial |
$1,088.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,421.00
|
| Rate for Payer: PACE SWMI |
$907.23
|
| Rate for Payer: PHP Medicare Advantage |
$907.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$589.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,627.86
|
| Rate for Payer: Priority Health Medicare |
$907.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,627.86
|
| Rate for Payer: Railroad Medicare Medicare |
$907.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,760.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$907.23
|
| Rate for Payer: UHC Exchange |
$1,760.25
|
| Rate for Payer: UHC Medicaid |
$589.37
|
| Rate for Payer: UHCCP DNSP |
$907.23
|
| Rate for Payer: UHCCP Medicaid |
$589.37
|
|
|
PR PENG BENZATHINE/PROCAINE INJ
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS J0558
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$28.11 |
| Rate for Payer: Aetna Commercial |
$26.16
|
| Rate for Payer: Aetna Medicare |
$19.52
|
| Rate for Payer: BCBS MAPPO |
$19.52
|
| Rate for Payer: BCBS Trust/PPO |
$19.89
|
| Rate for Payer: BCN Commercial |
$17.69
|
| Rate for Payer: BCN Medicare Advantage |
$19.52
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$28.11
|
| Rate for Payer: Cofinity Commercial |
$26.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.52
|
| Rate for Payer: Healthscope Commercial |
$23.42
|
| Rate for Payer: Healthscope Whirlpool |
$23.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.47
|
| Rate for Payer: Nomi Health Commercial |
$23.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.50
|
| Rate for Payer: PACE SWMI |
$19.52
|
| Rate for Payer: PHP Medicare Advantage |
$19.52
|
| Rate for Payer: Priority Health Medicare |
$19.52
|
| Rate for Payer: Railroad Medicare Medicare |
$19.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.52
|
| Rate for Payer: UHC Exchange |
$19.52
|
| Rate for Payer: UHCCP DNSP |
$19.52
|
|
|
PR PENICILLIN G BENZATHINE INJ
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J0561
|
| Min. Negotiated Rate |
$7.50 |
| Max. Negotiated Rate |
$45.32 |
| Rate for Payer: Aetna Commercial |
$42.17
|
| Rate for Payer: Aetna Medicare |
$31.47
|
| Rate for Payer: BCBS MAPPO |
$31.47
|
| Rate for Payer: BCBS Trust/PPO |
$33.85
|
| Rate for Payer: BCN Commercial |
$27.98
|
| Rate for Payer: BCN Medicare Advantage |
$31.47
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$45.32
|
| Rate for Payer: Cofinity Commercial |
$42.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$37.76
|
| Rate for Payer: Healthscope Whirlpool |
$37.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.62
|
| Rate for Payer: Nomi Health Commercial |
$37.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$31.47
|
| Rate for Payer: PHP Medicare Advantage |
$31.47
|
| Rate for Payer: Priority Health Medicare |
$31.47
|
| Rate for Payer: Railroad Medicare Medicare |
$31.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.47
|
| Rate for Payer: UHC Exchange |
$31.97
|
| Rate for Payer: UHCCP DNSP |
$31.47
|
|
|
PR PENILE PLETHYSMOGRAPHY
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 54240
|
| Min. Negotiated Rate |
$108.54 |
| Max. Negotiated Rate |
$177.38 |
| Rate for Payer: Aetna Commercial |
$145.44
|
| Rate for Payer: Aetna Medicare |
$108.54
|
| Rate for Payer: BCBS MAPPO |
$108.54
|
| Rate for Payer: BCN Commercial |
$162.84
|
| Rate for Payer: BCN Medicare Advantage |
$108.54
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Cofinity Commercial |
$156.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.54
|
| Rate for Payer: Healthscope Commercial |
$130.25
|
| Rate for Payer: Healthscope Whirlpool |
$130.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$119.39
|
| Rate for Payer: Nomi Health Commercial |
$130.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.50
|
| Rate for Payer: PACE SWMI |
$108.54
|
| Rate for Payer: PHP Medicare Advantage |
$108.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$177.38
|
| Rate for Payer: Priority Health Medicare |
$108.54
|
| Rate for Payer: Priority Health Narrow Network |
$177.38
|
| Rate for Payer: Railroad Medicare Medicare |
$108.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$108.54
|
| Rate for Payer: UHC Exchange |
$176.66
|
| Rate for Payer: UHCCP DNSP |
$108.54
|
|
|
PR PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR
|
Professional
|
Both
|
$5,356.00
|
|
|
Service Code
|
HCPCS 54304
|
| Min. Negotiated Rate |
$431.11 |
| Max. Negotiated Rate |
$4,017.00 |
| Rate for Payer: Aetna Commercial |
$893.55
|
| Rate for Payer: Aetna Medicare |
$666.83
|
| Rate for Payer: BCBS Complete |
$452.67
|
| Rate for Payer: BCBS MAPPO |
$666.83
|
| Rate for Payer: BCN Commercial |
$1,119.46
|
| Rate for Payer: BCN Medicare Advantage |
$666.83
|
| Rate for Payer: Cash Price |
$4,284.80
|
| Rate for Payer: Cash Price |
$4,284.80
|
| Rate for Payer: Cofinity Commercial |
$960.24
|
| Rate for Payer: Cofinity Commercial |
$893.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.83
|
| Rate for Payer: Healthscope Commercial |
$800.20
|
| Rate for Payer: Healthscope Whirlpool |
$800.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.17
|
| Rate for Payer: Meridian Medicaid |
$452.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$733.51
|
| Rate for Payer: Nomi Health Commercial |
$800.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,017.00
|
| Rate for Payer: PACE SWMI |
$666.83
|
| Rate for Payer: PHP Medicare Advantage |
$666.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,219.46
|
| Rate for Payer: Priority Health Medicare |
$666.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,219.46
|
| Rate for Payer: Railroad Medicare Medicare |
$666.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,321.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$666.83
|
| Rate for Payer: UHC Exchange |
$1,321.67
|
| Rate for Payer: UHC Medicaid |
$431.11
|
| Rate for Payer: UHCCP DNSP |
$666.83
|
| Rate for Payer: UHCCP Medicaid |
$431.11
|
|
|
PR PENIS STRAIGHTENING CHORDEE
|
Professional
|
Both
|
$1,376.00
|
|
|
Service Code
|
HCPCS 54300
|
| Min. Negotiated Rate |
$375.31 |
| Max. Negotiated Rate |
$1,136.46 |
| Rate for Payer: Aetna Commercial |
$776.36
|
| Rate for Payer: Aetna Medicare |
$579.37
|
| Rate for Payer: BCBS Complete |
$394.08
|
| Rate for Payer: BCBS MAPPO |
$579.37
|
| Rate for Payer: BCN Commercial |
$968.58
|
| Rate for Payer: BCN Medicare Advantage |
$579.37
|
| Rate for Payer: Cash Price |
$1,100.80
|
| Rate for Payer: Cash Price |
$1,100.80
|
| Rate for Payer: Cofinity Commercial |
$834.29
|
| Rate for Payer: Cofinity Commercial |
$776.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.37
|
| Rate for Payer: Healthscope Commercial |
$695.24
|
| Rate for Payer: Healthscope Whirlpool |
$695.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.34
|
| Rate for Payer: Meridian Medicaid |
$394.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$637.31
|
| Rate for Payer: Nomi Health Commercial |
$695.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,032.00
|
| Rate for Payer: PACE SWMI |
$579.37
|
| Rate for Payer: PHP Medicare Advantage |
$579.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,055.09
|
| Rate for Payer: Priority Health Medicare |
$579.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,055.09
|
| Rate for Payer: Railroad Medicare Medicare |
$579.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,136.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$579.37
|
| Rate for Payer: UHC Exchange |
$1,136.46
|
| Rate for Payer: UHC Medicaid |
$375.31
|
| Rate for Payer: UHCCP DNSP |
$579.37
|
| Rate for Payer: UHCCP Medicaid |
$375.31
|
|
|
PR PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 94642
|
| Min. Negotiated Rate |
$18.04 |
| Max. Negotiated Rate |
$190.17 |
| Rate for Payer: Aetna Commercial |
$46.35
|
| Rate for Payer: BCBS Complete |
$18.94
|
| Rate for Payer: BCN Commercial |
$190.17
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Meridian Medicaid |
$18.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$59.25
|
| Rate for Payer: Priority Health Narrow Network |
$59.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.22
|
| Rate for Payer: UHC Exchange |
$47.22
|
| Rate for Payer: UHC Medicaid |
$18.04
|
| Rate for Payer: UHCCP Medicaid |
$18.04
|
|
|
PR PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 92972
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$243.43 |
| Rate for Payer: Aetna Commercial |
$162.88
|
| Rate for Payer: Aetna Medicare |
$121.55
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCBS MAPPO |
$121.55
|
| Rate for Payer: BCN Commercial |
$214.63
|
| Rate for Payer: BCN Medicare Advantage |
$121.55
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$175.03
|
| Rate for Payer: Cofinity Commercial |
$162.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.55
|
| Rate for Payer: Healthscope Commercial |
$145.86
|
| Rate for Payer: Healthscope Whirlpool |
$145.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.63
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$145.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.00
|
| Rate for Payer: PACE SWMI |
$121.55
|
| Rate for Payer: PHP Medicare Advantage |
$121.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.99
|
| Rate for Payer: Priority Health Medicare |
$121.55
|
| Rate for Payer: Priority Health Narrow Network |
$203.99
|
| Rate for Payer: Railroad Medicare Medicare |
$121.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.55
|
| Rate for Payer: UHC Exchange |
$243.43
|
| Rate for Payer: UHC Medicaid |
$77.96
|
| Rate for Payer: UHCCP DNSP |
$121.55
|
| Rate for Payer: UHCCP Medicaid |
$77.96
|
|
|
PR PERCUTANEOUS TX MALAR AREA FRACTURE
|
Professional
|
Both
|
$943.00
|
|
|
Service Code
|
HCPCS 21355
|
| Min. Negotiated Rate |
$187.65 |
| Max. Negotiated Rate |
$707.25 |
| Rate for Payer: Aetna Commercial |
$382.90
|
| Rate for Payer: Aetna Medicare |
$285.75
|
| Rate for Payer: BCBS Complete |
$197.03
|
| Rate for Payer: BCBS MAPPO |
$285.75
|
| Rate for Payer: BCN Commercial |
$497.49
|
| Rate for Payer: BCN Medicare Advantage |
$285.75
|
| Rate for Payer: Cash Price |
$754.40
|
| Rate for Payer: Cash Price |
$754.40
|
| Rate for Payer: Cofinity Commercial |
$382.90
|
| Rate for Payer: Cofinity Commercial |
$411.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.75
|
| Rate for Payer: Healthscope Commercial |
$342.90
|
| Rate for Payer: Healthscope Whirlpool |
$342.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.04
|
| Rate for Payer: Meridian Medicaid |
$197.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$314.32
|
| Rate for Payer: Nomi Health Commercial |
$342.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.25
|
| Rate for Payer: PACE SWMI |
$285.75
|
| Rate for Payer: PHP Medicare Advantage |
$285.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$531.79
|
| Rate for Payer: Priority Health Medicare |
$285.75
|
| Rate for Payer: Priority Health Narrow Network |
$531.79
|
| Rate for Payer: Railroad Medicare Medicare |
$285.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$554.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$285.75
|
| Rate for Payer: UHC Exchange |
$554.38
|
| Rate for Payer: UHC Medicaid |
$187.65
|
| Rate for Payer: UHCCP DNSP |
$285.75
|
| Rate for Payer: UHCCP Medicaid |
$187.65
|
|
|
PR PERCUTANEOUS VERTEBROPLASTY EA ADDL THRC/LMBR
|
Professional
|
Both
|
$741.00
|
|
|
Service Code
|
HCPCS 22522
|
| Min. Negotiated Rate |
$296.40 |
| Max. Negotiated Rate |
$555.75 |
| Rate for Payer: BCBS Complete |
$296.40
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.75
|
|
