|
PR PRCTECT PRTL RESCJ RECTUM TABDL APPR
|
Professional
|
Both
|
$2,032.00
|
|
|
Service Code
|
HCPCS 45111
|
| Min. Negotiated Rate |
$644.54 |
| Max. Negotiated Rate |
$1,977.42 |
| Rate for Payer: Aetna Commercial |
$1,340.00
|
| Rate for Payer: Aetna Medicare |
$1,000.00
|
| Rate for Payer: BCBS Complete |
$676.77
|
| Rate for Payer: BCBS MAPPO |
$1,000.00
|
| Rate for Payer: BCN Commercial |
$1,622.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,000.00
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cofinity Commercial |
$1,440.00
|
| Rate for Payer: Cofinity Commercial |
$1,340.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,000.00
|
| Rate for Payer: Healthscope Commercial |
$1,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,200.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,050.00
|
| Rate for Payer: Meridian Medicaid |
$676.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,100.00
|
| Rate for Payer: Nomi Health Commercial |
$1,200.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,524.00
|
| Rate for Payer: PACE SWMI |
$1,000.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,000.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,977.42
|
| Rate for Payer: Priority Health Medicare |
$1,000.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,977.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,000.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,924.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,000.00
|
| Rate for Payer: UHC Exchange |
$1,924.58
|
| Rate for Payer: UHC Medicaid |
$644.54
|
| Rate for Payer: UHCCP DNSP |
$1,000.00
|
| Rate for Payer: UHCCP Medicaid |
$644.54
|
|
|
PR PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH
|
Professional
|
Both
|
$3,357.00
|
|
|
Service Code
|
HCPCS 45114
|
| Min. Negotiated Rate |
$1,076.72 |
| Max. Negotiated Rate |
$3,318.36 |
| Rate for Payer: Aetna Commercial |
$2,260.16
|
| Rate for Payer: Aetna Medicare |
$1,686.69
|
| Rate for Payer: BCBS Complete |
$1,130.56
|
| Rate for Payer: BCBS MAPPO |
$1,686.69
|
| Rate for Payer: BCN Commercial |
$2,723.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,686.69
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cofinity Commercial |
$2,428.83
|
| Rate for Payer: Cofinity Commercial |
$2,260.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,686.69
|
| Rate for Payer: Healthscope Commercial |
$2,024.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,024.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,771.02
|
| Rate for Payer: Meridian Medicaid |
$1,130.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,855.36
|
| Rate for Payer: Nomi Health Commercial |
$2,024.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,517.75
|
| Rate for Payer: PACE SWMI |
$1,686.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,686.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,076.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,318.36
|
| Rate for Payer: Priority Health Medicare |
$1,686.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,318.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,686.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,250.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,686.69
|
| Rate for Payer: UHC Exchange |
$3,250.86
|
| Rate for Payer: UHC Medicaid |
$1,076.72
|
| Rate for Payer: UHCCP DNSP |
$1,686.69
|
| Rate for Payer: UHCCP Medicaid |
$1,076.72
|
|
|
PR PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY
|
Professional
|
Both
|
$3,925.00
|
|
|
Service Code
|
HCPCS 45116
|
| Min. Negotiated Rate |
$897.16 |
| Max. Negotiated Rate |
$2,943.75 |
| Rate for Payer: Aetna Commercial |
$1,864.02
|
| Rate for Payer: Aetna Medicare |
$1,391.06
|
| Rate for Payer: BCBS Complete |
$942.02
|
| Rate for Payer: BCBS MAPPO |
$1,391.06
|
| Rate for Payer: BCN Commercial |
$2,295.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,391.06
|
| Rate for Payer: Cash Price |
$3,140.00
|
| Rate for Payer: Cash Price |
$3,140.00
|
| Rate for Payer: Cofinity Commercial |
$2,003.13
|
| Rate for Payer: Cofinity Commercial |
$1,864.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,391.06
|
| Rate for Payer: Healthscope Commercial |
$1,669.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,669.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,460.61
|
| Rate for Payer: Meridian Medicaid |
$942.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,530.17
|
| Rate for Payer: Nomi Health Commercial |
$1,669.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,943.75
|
| Rate for Payer: PACE SWMI |
$1,391.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,391.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$897.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,797.14
|
| Rate for Payer: Priority Health Medicare |
$1,391.06
|
| Rate for Payer: Priority Health Narrow Network |
$2,797.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,391.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,734.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,391.06
|
| Rate for Payer: UHC Exchange |
$2,734.18
|
| Rate for Payer: UHC Medicaid |
$897.16
|
| Rate for Payer: UHCCP DNSP |
$1,391.06
|
| Rate for Payer: UHCCP Medicaid |
$897.16
|
|
|
PR PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR
|
Professional
|
Both
|
$5,619.00
|
|
|
Service Code
|
HCPCS 45113
|
| Min. Negotiated Rate |
$1,081.19 |
| Max. Negotiated Rate |
$4,214.25 |
| Rate for Payer: Aetna Commercial |
$2,245.40
|
| Rate for Payer: Aetna Medicare |
$1,675.67
|
| Rate for Payer: BCBS Complete |
$1,135.25
|
| Rate for Payer: BCBS MAPPO |
$1,675.67
|
| Rate for Payer: BCN Commercial |
$2,763.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,675.67
|
| Rate for Payer: Cash Price |
$4,495.20
|
| Rate for Payer: Cash Price |
$4,495.20
|
| Rate for Payer: Cofinity Commercial |
$2,412.96
|
| Rate for Payer: Cofinity Commercial |
$2,245.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,675.67
|
| Rate for Payer: Healthscope Commercial |
$2,010.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,010.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,759.45
|
| Rate for Payer: Meridian Medicaid |
$1,135.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,843.24
|
| Rate for Payer: Nomi Health Commercial |
$2,010.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,214.25
|
| Rate for Payer: PACE SWMI |
$1,675.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,675.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,081.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,367.50
|
| Rate for Payer: Priority Health Medicare |
$1,675.67
|
| Rate for Payer: Priority Health Narrow Network |
$3,367.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,675.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,314.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,675.67
|
| Rate for Payer: UHC Exchange |
$3,314.28
|
| Rate for Payer: UHC Medicaid |
$1,081.19
|
| Rate for Payer: UHCCP DNSP |
$1,675.67
|
| Rate for Payer: UHCCP Medicaid |
$1,081.19
|
|
|
PR PRCTECT PRTL W/O ANAST PRNL APPR
|
Professional
|
Both
|
$3,138.00
|
|
|
Service Code
|
HCPCS 45123
|
| Min. Negotiated Rate |
$658.60 |
| Max. Negotiated Rate |
$2,353.50 |
| Rate for Payer: Aetna Commercial |
$1,366.81
|
| Rate for Payer: Aetna Medicare |
$1,020.01
|
| Rate for Payer: BCBS Complete |
$691.53
|
| Rate for Payer: BCBS MAPPO |
$1,020.01
|
| Rate for Payer: BCN Commercial |
$1,661.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.01
|
| Rate for Payer: Cash Price |
$2,510.40
|
| Rate for Payer: Cash Price |
$2,510.40
|
| Rate for Payer: Cofinity Commercial |
$1,366.81
|
| Rate for Payer: Cofinity Commercial |
$1,468.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.01
|
| Rate for Payer: Healthscope Commercial |
$1,224.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,224.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,071.01
|
| Rate for Payer: Meridian Medicaid |
$691.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,122.01
|
| Rate for Payer: Nomi Health Commercial |
$1,224.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,353.50
|
| Rate for Payer: PACE SWMI |
$1,020.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,024.74
|
| Rate for Payer: Priority Health Medicare |
$1,020.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,024.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,020.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,969.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,020.01
|
| Rate for Payer: UHC Exchange |
$1,969.47
|
| Rate for Payer: UHC Medicaid |
$658.60
|
| Rate for Payer: UHCCP DNSP |
$1,020.01
|
| Rate for Payer: UHCCP Medicaid |
$658.60
|
|
|
PR PREDNISONE IR OR DR ORAL 1MG
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J7512
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.01
|
|
|
PR PREDNISONE ORAL
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J7506
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.75
|
|
|
PR PREPARATION SKIN CELL SSP AGRFT 1ST 25 SQ CM/<
|
Professional
|
Both
|
$9,709.00
|
|
|
Service Code
|
HCPCS 15013
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$9,376.33 |
| Rate for Payer: BCBS Complete |
$44.09
|
| Rate for Payer: BCN Commercial |
$6,779.22
|
| Rate for Payer: Cash Price |
$7,767.20
|
| Rate for Payer: Cash Price |
$7,767.20
|
| Rate for Payer: Meridian Medicaid |
$44.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,281.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,376.33
|
| Rate for Payer: Priority Health Narrow Network |
$9,376.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.65
|
| Rate for Payer: UHC Exchange |
$148.65
|
| Rate for Payer: UHC Medicaid |
$41.99
|
| Rate for Payer: UHCCP Medicaid |
$41.99
|
|
|
PR PREPARATION SKIN CELL SSP AGRFT EA ADDL 25 SQ CM
|
Professional
|
Both
|
$9,709.00
|
|
|
Service Code
|
HCPCS 15014
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$7,281.75 |
| Rate for Payer: BCBS Complete |
$44.09
|
| Rate for Payer: Cash Price |
$7,767.20
|
| Rate for Payer: Cash Price |
$7,767.20
|
| Rate for Payer: Meridian Medicaid |
$44.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,281.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.65
|
| Rate for Payer: UHC Exchange |
$148.65
|
| Rate for Payer: UHC Medicaid |
$41.99
|
| Rate for Payer: UHCCP Medicaid |
$41.99
|
|
|
PR PREPARE FECAL MICROBIOTA FOR INSTILLATION
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 44705
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$96.49
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCN Commercial |
$106.57
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$129.84
|
| Rate for Payer: Priority Health Narrow Network |
$129.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.68
|
| Rate for Payer: UHC Exchange |
$127.68
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
|
PR PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 49013
|
| Min. Negotiated Rate |
$261.56 |
| Max. Negotiated Rate |
$826.40 |
| Rate for Payer: Aetna Commercial |
$554.48
|
| Rate for Payer: Aetna Medicare |
$413.79
|
| Rate for Payer: BCBS Complete |
$274.64
|
| Rate for Payer: BCBS MAPPO |
$413.79
|
| Rate for Payer: BCN Commercial |
$678.25
|
| Rate for Payer: BCN Medicare Advantage |
$413.79
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cofinity Commercial |
$595.86
|
| Rate for Payer: Cofinity Commercial |
$554.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.79
|
| Rate for Payer: Healthscope Commercial |
$496.55
|
| Rate for Payer: Healthscope Whirlpool |
$496.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.48
|
| Rate for Payer: Meridian Medicaid |
$274.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$455.17
|
| Rate for Payer: Nomi Health Commercial |
$496.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$727.50
|
| Rate for Payer: PACE SWMI |
$413.79
|
| Rate for Payer: PHP Medicare Advantage |
$413.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$826.40
|
| Rate for Payer: Priority Health Medicare |
$413.79
|
| Rate for Payer: Priority Health Narrow Network |
$826.40
|
| Rate for Payer: Railroad Medicare Medicare |
$413.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$782.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$413.79
|
| Rate for Payer: UHC Exchange |
$782.41
|
| Rate for Payer: UHC Medicaid |
$261.56
|
| Rate for Payer: UHCCP DNSP |
$413.79
|
| Rate for Payer: UHCCP Medicaid |
$261.56
|
|
|
PR PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$690.00
|
|
|
Service Code
|
HCPCS 15004
|
| Min. Negotiated Rate |
$145.91 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Aetna Commercial |
$303.31
|
| Rate for Payer: Aetna Medicare |
$226.35
|
| Rate for Payer: BCBS Complete |
$153.21
|
| Rate for Payer: BCBS MAPPO |
$226.35
|
| Rate for Payer: BCN Commercial |
$388.92
|
| Rate for Payer: BCN Medicare Advantage |
$226.35
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cofinity Commercial |
$325.94
|
| Rate for Payer: Cofinity Commercial |
$303.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.35
|
| Rate for Payer: Healthscope Commercial |
$271.62
|
| Rate for Payer: Healthscope Whirlpool |
$271.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.67
|
| Rate for Payer: Meridian Medicaid |
$153.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.99
|
| Rate for Payer: Nomi Health Commercial |
$271.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.50
|
| Rate for Payer: PACE SWMI |
$226.35
|
| Rate for Payer: PHP Medicare Advantage |
$226.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$355.97
|
| Rate for Payer: Priority Health Medicare |
$226.35
|
| Rate for Payer: Priority Health Narrow Network |
$355.97
|
| Rate for Payer: Railroad Medicare Medicare |
$226.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$467.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.35
|
| Rate for Payer: UHC Exchange |
$467.28
|
| Rate for Payer: UHC Medicaid |
$145.91
|
| Rate for Payer: UHCCP DNSP |
$226.35
|
| Rate for Payer: UHCCP Medicaid |
$145.91
|
|
|
PR PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 15005
|
| Min. Negotiated Rate |
$49.84 |
| Max. Negotiated Rate |
$163.07 |
| Rate for Payer: Aetna Commercial |
$104.98
|
| Rate for Payer: Aetna Medicare |
$78.34
|
| Rate for Payer: BCBS Complete |
$52.33
|
| Rate for Payer: BCBS MAPPO |
$78.34
|
| Rate for Payer: BCN Commercial |
$133.46
|
| Rate for Payer: BCN Medicare Advantage |
$78.34
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$112.81
|
| Rate for Payer: Cofinity Commercial |
$104.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.34
|
| Rate for Payer: Healthscope Commercial |
$94.01
|
| Rate for Payer: Healthscope Whirlpool |
$94.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.26
|
| Rate for Payer: Meridian Medicaid |
$52.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.17
|
| Rate for Payer: Nomi Health Commercial |
$94.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$78.34
|
| Rate for Payer: PHP Medicare Advantage |
$78.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$122.15
|
| Rate for Payer: Priority Health Medicare |
$78.34
|
| Rate for Payer: Priority Health Narrow Network |
$122.15
|
| Rate for Payer: Railroad Medicare Medicare |
$78.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.34
|
| Rate for Payer: UHC Exchange |
$163.07
|
| Rate for Payer: UHC Medicaid |
$49.84
|
| Rate for Payer: UHCCP DNSP |
$78.34
|
| Rate for Payer: UHCCP Medicaid |
$49.84
|
|
|
PR PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$579.00
|
|
|
Service Code
|
HCPCS 15002
|
| Min. Negotiated Rate |
$125.67 |
| Max. Negotiated Rate |
$434.25 |
| Rate for Payer: Aetna Commercial |
$261.25
|
| Rate for Payer: Aetna Medicare |
$194.96
|
| Rate for Payer: BCBS Complete |
$131.95
|
| Rate for Payer: BCBS MAPPO |
$194.96
|
| Rate for Payer: BCN Commercial |
$328.67
|
| Rate for Payer: BCN Medicare Advantage |
$194.96
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cofinity Commercial |
$280.74
|
| Rate for Payer: Cofinity Commercial |
$261.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.96
|
| Rate for Payer: Healthscope Commercial |
$233.95
|
| Rate for Payer: Healthscope Whirlpool |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.71
|
| Rate for Payer: Meridian Medicaid |
$131.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$214.46
|
| Rate for Payer: Nomi Health Commercial |
$233.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$434.25
|
| Rate for Payer: PACE SWMI |
$194.96
|
| Rate for Payer: PHP Medicare Advantage |
$194.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$300.82
|
| Rate for Payer: Priority Health Medicare |
$194.96
|
| Rate for Payer: Priority Health Narrow Network |
$300.82
|
| Rate for Payer: Railroad Medicare Medicare |
$194.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$393.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$194.96
|
| Rate for Payer: UHC Exchange |
$393.47
|
| Rate for Payer: UHC Medicaid |
$125.67
|
| Rate for Payer: UHCCP DNSP |
$194.96
|
| Rate for Payer: UHCCP Medicaid |
$125.67
|
|
|
PR PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 15003
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$39.85
|
| Rate for Payer: BCBS Complete |
$26.62
|
| Rate for Payer: BCBS MAPPO |
$39.85
|
| Rate for Payer: BCN Commercial |
$66.24
|
| Rate for Payer: BCN Medicare Advantage |
$39.85
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$57.38
|
| Rate for Payer: Cofinity Commercial |
$53.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.85
|
| Rate for Payer: Healthscope Commercial |
$47.82
|
| Rate for Payer: Healthscope Whirlpool |
$47.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.84
|
| Rate for Payer: Meridian Medicaid |
$26.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.84
|
| Rate for Payer: Nomi Health Commercial |
$47.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
| Rate for Payer: PACE SWMI |
$39.85
|
| Rate for Payer: PHP Medicare Advantage |
$39.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$60.62
|
| Rate for Payer: Priority Health Medicare |
$39.85
|
| Rate for Payer: Priority Health Narrow Network |
$60.62
|
| Rate for Payer: Railroad Medicare Medicare |
$39.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.85
|
| Rate for Payer: UHC Exchange |
$80.96
|
| Rate for Payer: UHC Medicaid |
$25.35
|
| Rate for Payer: UHCCP DNSP |
$39.85
|
| Rate for Payer: UHCCP Medicaid |
$25.35
|
|
|
PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 94640
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Commercial |
$10.72
|
| Rate for Payer: Aetna Medicare |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$8.00
|
| Rate for Payer: BCN Commercial |
$11.95
|
| Rate for Payer: BCN Medicare Advantage |
$8.00
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$10.72
|
| Rate for Payer: Cofinity Commercial |
$11.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.00
|
| Rate for Payer: Healthscope Commercial |
$9.60
|
| Rate for Payer: Healthscope Whirlpool |
$9.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.80
|
| Rate for Payer: Nomi Health Commercial |
$9.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PACE SWMI |
$8.00
|
| Rate for Payer: PHP Medicare Advantage |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11.02
|
| Rate for Payer: Priority Health Medicare |
$8.00
|
| Rate for Payer: Priority Health Narrow Network |
$11.02
|
| Rate for Payer: Railroad Medicare Medicare |
$8.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.00
|
| Rate for Payer: UHC Exchange |
$26.63
|
| Rate for Payer: UHCCP DNSP |
$8.00
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 15 MIN
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 99401
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$25.12
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$31.35
|
| Rate for Payer: Priority Health Narrow Network |
$31.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.60
|
| Rate for Payer: UHC Exchange |
$35.60
|
| Rate for Payer: UHC Medicaid |
$13.21
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 30 MIN
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 99402
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$87.75 |
| Rate for Payer: Aetna Commercial |
$51.32
|
| Rate for Payer: BCBS Complete |
$28.18
|
| Rate for Payer: BCN Commercial |
$70.22
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Meridian Medicaid |
$28.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$63.16
|
| Rate for Payer: Priority Health Narrow Network |
$63.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.65
|
| Rate for Payer: UHC Exchange |
$72.65
|
| Rate for Payer: UHC Medicaid |
$26.84
|
| Rate for Payer: UHCCP Medicaid |
$26.84
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 45 MIN
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 99403
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$113.25 |
| Rate for Payer: Aetna Commercial |
$76.44
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCN Commercial |
$105.08
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Meridian Medicaid |
$41.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$94.51
|
| Rate for Payer: Priority Health Narrow Network |
$94.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.71
|
| Rate for Payer: UHC Exchange |
$106.71
|
| Rate for Payer: UHC Medicaid |
$39.62
|
| Rate for Payer: UHCCP Medicaid |
$39.62
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 60 MIN
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 99404
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Aetna Commercial |
$101.22
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCN Commercial |
$141.92
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$127.67
|
| Rate for Payer: Priority Health Narrow Network |
$127.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.78
|
| Rate for Payer: UHC Exchange |
$142.78
|
| Rate for Payer: UHC Medicaid |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
|
|
PR PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 99412
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$13.09
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCN Commercial |
$18.43
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16.58
|
| Rate for Payer: Priority Health Narrow Network |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.53
|
| Rate for Payer: UHC Exchange |
$18.53
|
|
|
PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 93279
|
| Min. Negotiated Rate |
$63.04 |
| Max. Negotiated Rate |
$129.75 |
| Rate for Payer: Aetna Commercial |
$84.47
|
| Rate for Payer: Aetna Medicare |
$63.04
|
| Rate for Payer: BCBS MAPPO |
$63.04
|
| Rate for Payer: BCN Commercial |
$99.10
|
| Rate for Payer: BCN Medicare Advantage |
$63.04
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$90.78
|
| Rate for Payer: Cofinity Commercial |
$84.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.04
|
| Rate for Payer: Healthscope Commercial |
$75.65
|
| Rate for Payer: Healthscope Whirlpool |
$75.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.34
|
| Rate for Payer: Nomi Health Commercial |
$75.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.75
|
| Rate for Payer: PACE SWMI |
$63.04
|
| Rate for Payer: PHP Medicare Advantage |
$63.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$94.19
|
| Rate for Payer: Priority Health Medicare |
$63.04
|
| Rate for Payer: Priority Health Narrow Network |
$94.19
|
| Rate for Payer: Railroad Medicare Medicare |
$63.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.04
|
| Rate for Payer: UHC Exchange |
$94.80
|
| Rate for Payer: UHCCP DNSP |
$63.04
|
|
|
PR PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 0826T
|
| Min. Negotiated Rate |
$34.87 |
| Max. Negotiated Rate |
$109.77 |
| Rate for Payer: BCBS Complete |
$38.40
|
| Rate for Payer: BCN Commercial |
$34.87
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.77
|
| Rate for Payer: UHC Exchange |
$109.77
|
|
|
PR PRGRMG DEV EVAL LDLS PM SYS 2CHMBR IN PERSON
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 0804T
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$131.01 |
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCN Commercial |
$115.53
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.01
|
| Rate for Payer: UHC Exchange |
$131.01
|
|
|
PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 93285
|
| Min. Negotiated Rate |
$55.98 |
| Max. Negotiated Rate |
$87.65 |
| Rate for Payer: Aetna Commercial |
$75.01
|
| Rate for Payer: Aetna Commercial |
$75.01
|
| Rate for Payer: Aetna Medicare |
$55.98
|
| Rate for Payer: Aetna Medicare |
$55.98
|
| Rate for Payer: BCBS MAPPO |
$55.98
|
| Rate for Payer: BCBS MAPPO |
$55.98
|
| Rate for Payer: BCN Commercial |
$87.65
|
| Rate for Payer: BCN Commercial |
$87.65
|
| Rate for Payer: BCN Medicare Advantage |
$55.98
|
| Rate for Payer: BCN Medicare Advantage |
$55.98
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$75.01
|
| Rate for Payer: Cofinity Commercial |
$80.61
|
| Rate for Payer: Cofinity Commercial |
$80.61
|
| Rate for Payer: Cofinity Commercial |
$75.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.98
|
| Rate for Payer: Healthscope Commercial |
$67.18
|
| Rate for Payer: Healthscope Commercial |
$67.18
|
| Rate for Payer: Healthscope Whirlpool |
$67.18
|
| Rate for Payer: Healthscope Whirlpool |
$67.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.58
|
| Rate for Payer: Nomi Health Commercial |
$67.18
|
| Rate for Payer: Nomi Health Commercial |
$67.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: PACE SWMI |
$55.98
|
| Rate for Payer: PACE SWMI |
$55.98
|
| Rate for Payer: PHP Medicare Advantage |
$55.98
|
| Rate for Payer: PHP Medicare Advantage |
$55.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$83.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$83.30
|
| Rate for Payer: Priority Health Medicare |
$55.98
|
| Rate for Payer: Priority Health Medicare |
$55.98
|
| Rate for Payer: Priority Health Narrow Network |
$83.30
|
| Rate for Payer: Priority Health Narrow Network |
$83.30
|
| Rate for Payer: Railroad Medicare Medicare |
$55.98
|
| Rate for Payer: Railroad Medicare Medicare |
$55.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.98
|
| Rate for Payer: UHC Exchange |
$83.53
|
| Rate for Payer: UHC Exchange |
$83.53
|
| Rate for Payer: UHCCP DNSP |
$55.98
|
| Rate for Payer: UHCCP DNSP |
$55.98
|
|
