|
PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 93284
|
| Min. Negotiated Rate |
$99.05 |
| Max. Negotiated Rate |
$155.86 |
| Rate for Payer: Aetna Commercial |
$132.73
|
| Rate for Payer: Aetna Medicare |
$99.05
|
| Rate for Payer: BCBS MAPPO |
$99.05
|
| Rate for Payer: BCN Commercial |
$155.37
|
| Rate for Payer: BCN Medicare Advantage |
$99.05
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$132.73
|
| Rate for Payer: Cofinity Commercial |
$142.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.05
|
| Rate for Payer: Healthscope Commercial |
$118.86
|
| Rate for Payer: Healthscope Whirlpool |
$118.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.95
|
| Rate for Payer: Nomi Health Commercial |
$118.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.25
|
| Rate for Payer: PACE SWMI |
$99.05
|
| Rate for Payer: PHP Medicare Advantage |
$99.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$147.67
|
| Rate for Payer: Priority Health Medicare |
$99.05
|
| Rate for Payer: Priority Health Narrow Network |
$147.67
|
| Rate for Payer: Railroad Medicare Medicare |
$99.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.05
|
| Rate for Payer: UHC Exchange |
$155.86
|
| Rate for Payer: UHCCP DNSP |
$99.05
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS 93283
|
| Min. Negotiated Rate |
$91.75 |
| Max. Negotiated Rate |
$144.21 |
| Rate for Payer: Aetna Commercial |
$122.94
|
| Rate for Payer: Aetna Medicare |
$91.75
|
| Rate for Payer: BCBS MAPPO |
$91.75
|
| Rate for Payer: BCN Commercial |
$143.92
|
| Rate for Payer: BCN Medicare Advantage |
$91.75
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$122.94
|
| Rate for Payer: Cofinity Commercial |
$132.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.75
|
| Rate for Payer: Healthscope Commercial |
$110.10
|
| Rate for Payer: Healthscope Whirlpool |
$110.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.92
|
| Rate for Payer: Nomi Health Commercial |
$110.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.25
|
| Rate for Payer: PACE SWMI |
$91.75
|
| Rate for Payer: PHP Medicare Advantage |
$91.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$136.78
|
| Rate for Payer: Priority Health Medicare |
$91.75
|
| Rate for Payer: Priority Health Narrow Network |
$136.78
|
| Rate for Payer: Railroad Medicare Medicare |
$91.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.75
|
| Rate for Payer: UHC Exchange |
$144.21
|
| Rate for Payer: UHCCP DNSP |
$91.75
|
|
|
PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 93282
|
| Min. Negotiated Rate |
$74.36 |
| Max. Negotiated Rate |
$117.02 |
| Rate for Payer: Aetna Commercial |
$99.64
|
| Rate for Payer: Aetna Medicare |
$74.36
|
| Rate for Payer: BCBS MAPPO |
$74.36
|
| Rate for Payer: BCN Commercial |
$117.02
|
| Rate for Payer: BCN Medicare Advantage |
$74.36
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$107.08
|
| Rate for Payer: Cofinity Commercial |
$99.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.36
|
| Rate for Payer: Healthscope Commercial |
$89.23
|
| Rate for Payer: Healthscope Whirlpool |
$89.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.80
|
| Rate for Payer: Nomi Health Commercial |
$89.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.00
|
| Rate for Payer: PACE SWMI |
$74.36
|
| Rate for Payer: PHP Medicare Advantage |
$74.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.22
|
| Rate for Payer: Priority Health Medicare |
$74.36
|
| Rate for Payer: Priority Health Narrow Network |
$111.22
|
| Rate for Payer: Railroad Medicare Medicare |
$74.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.36
|
| Rate for Payer: UHC Exchange |
$114.97
|
| Rate for Payer: UHCCP DNSP |
$74.36
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS
|
Professional
|
Both
|
$5,898.00
|
|
|
Service Code
|
HCPCS 33031
|
| Min. Negotiated Rate |
$1,474.17 |
| Max. Negotiated Rate |
$4,423.50 |
| Rate for Payer: Aetna Commercial |
$3,104.20
|
| Rate for Payer: Aetna Medicare |
$2,316.57
|
| Rate for Payer: BCBS Complete |
$1,547.88
|
| Rate for Payer: BCBS MAPPO |
$2,316.57
|
| Rate for Payer: BCN Commercial |
$3,634.26
|
| Rate for Payer: BCN Medicare Advantage |
$2,316.57
|
| Rate for Payer: Cash Price |
$4,718.40
|
| Rate for Payer: Cash Price |
$4,718.40
|
| Rate for Payer: Cofinity Commercial |
$3,335.86
|
| Rate for Payer: Cofinity Commercial |
$3,104.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,316.57
|
| Rate for Payer: Healthscope Commercial |
$2,779.88
|
| Rate for Payer: Healthscope Whirlpool |
$2,779.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,432.40
|
| Rate for Payer: Meridian Medicaid |
$1,547.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,548.23
|
| Rate for Payer: Nomi Health Commercial |
$2,779.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,423.50
|
| Rate for Payer: PACE SWMI |
$2,316.57
|
| Rate for Payer: PHP Medicare Advantage |
$2,316.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,474.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,908.20
|
| Rate for Payer: Priority Health Medicare |
$2,316.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,908.20
|
| Rate for Payer: Railroad Medicare Medicare |
$2,316.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,414.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,316.57
|
| Rate for Payer: UHC Exchange |
$4,414.01
|
| Rate for Payer: UHC Medicaid |
$1,474.17
|
| Rate for Payer: UHCCP DNSP |
$2,316.57
|
| Rate for Payer: UHCCP Medicaid |
$1,474.17
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS
|
Professional
|
Both
|
$3,522.00
|
|
|
Service Code
|
HCPCS 33030
|
| Min. Negotiated Rate |
$1,197.49 |
| Max. Negotiated Rate |
$3,560.35 |
| Rate for Payer: Aetna Commercial |
$2,518.11
|
| Rate for Payer: Aetna Medicare |
$1,879.19
|
| Rate for Payer: BCBS Complete |
$1,257.36
|
| Rate for Payer: BCBS MAPPO |
$1,879.19
|
| Rate for Payer: BCN Commercial |
$2,945.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,879.19
|
| Rate for Payer: Cash Price |
$2,817.60
|
| Rate for Payer: Cash Price |
$2,817.60
|
| Rate for Payer: Cofinity Commercial |
$2,706.03
|
| Rate for Payer: Cofinity Commercial |
$2,518.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,879.19
|
| Rate for Payer: Healthscope Commercial |
$2,255.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,255.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,973.15
|
| Rate for Payer: Meridian Medicaid |
$1,257.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,067.11
|
| Rate for Payer: Nomi Health Commercial |
$2,255.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,641.50
|
| Rate for Payer: PACE SWMI |
$1,879.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,879.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,197.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,167.58
|
| Rate for Payer: Priority Health Medicare |
$1,879.19
|
| Rate for Payer: Priority Health Narrow Network |
$3,167.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,879.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,560.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,879.19
|
| Rate for Payer: UHC Exchange |
$3,560.35
|
| Rate for Payer: UHC Medicaid |
$1,197.49
|
| Rate for Payer: UHCCP DNSP |
$1,879.19
|
| Rate for Payer: UHCCP Medicaid |
$1,197.49
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST
|
Professional
|
Both
|
$4,257.00
|
|
|
Service Code
|
HCPCS 37184
|
| Min. Negotiated Rate |
$240.05 |
| Max. Negotiated Rate |
$3,192.75 |
| Rate for Payer: Aetna Commercial |
$507.06
|
| Rate for Payer: Aetna Medicare |
$378.40
|
| Rate for Payer: BCBS Complete |
$252.05
|
| Rate for Payer: BCBS MAPPO |
$378.40
|
| Rate for Payer: BCN Commercial |
$628.45
|
| Rate for Payer: BCN Medicare Advantage |
$378.40
|
| Rate for Payer: Cash Price |
$3,405.60
|
| Rate for Payer: Cash Price |
$3,405.60
|
| Rate for Payer: Cofinity Commercial |
$544.90
|
| Rate for Payer: Cofinity Commercial |
$507.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.40
|
| Rate for Payer: Healthscope Commercial |
$454.08
|
| Rate for Payer: Healthscope Whirlpool |
$454.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.32
|
| Rate for Payer: Meridian Medicaid |
$252.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$416.24
|
| Rate for Payer: Nomi Health Commercial |
$454.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,192.75
|
| Rate for Payer: PACE SWMI |
$378.40
|
| Rate for Payer: PHP Medicare Advantage |
$378.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$675.82
|
| Rate for Payer: Priority Health Medicare |
$378.40
|
| Rate for Payer: Priority Health Narrow Network |
$675.82
|
| Rate for Payer: Railroad Medicare Medicare |
$378.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$779.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$378.40
|
| Rate for Payer: UHC Exchange |
$779.82
|
| Rate for Payer: UHC Medicaid |
$240.05
|
| Rate for Payer: UHCCP DNSP |
$378.40
|
| Rate for Payer: UHCCP Medicaid |
$240.05
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ
|
Professional
|
Both
|
$3,543.00
|
|
|
Service Code
|
HCPCS 37185
|
| Min. Negotiated Rate |
$90.10 |
| Max. Negotiated Rate |
$2,657.25 |
| Rate for Payer: Aetna Commercial |
$191.02
|
| Rate for Payer: Aetna Medicare |
$142.55
|
| Rate for Payer: BCBS Complete |
$94.61
|
| Rate for Payer: BCBS MAPPO |
$142.55
|
| Rate for Payer: BCN Commercial |
$237.04
|
| Rate for Payer: BCN Medicare Advantage |
$142.55
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cofinity Commercial |
$205.27
|
| Rate for Payer: Cofinity Commercial |
$191.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.55
|
| Rate for Payer: Healthscope Commercial |
$171.06
|
| Rate for Payer: Healthscope Whirlpool |
$171.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.68
|
| Rate for Payer: Meridian Medicaid |
$94.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.81
|
| Rate for Payer: Nomi Health Commercial |
$171.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,657.25
|
| Rate for Payer: PACE SWMI |
$142.55
|
| Rate for Payer: PHP Medicare Advantage |
$142.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$254.91
|
| Rate for Payer: Priority Health Medicare |
$142.55
|
| Rate for Payer: Priority Health Narrow Network |
$254.91
|
| Rate for Payer: Railroad Medicare Medicare |
$142.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$294.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.55
|
| Rate for Payer: UHC Exchange |
$294.96
|
| Rate for Payer: UHC Medicaid |
$90.10
|
| Rate for Payer: UHCCP DNSP |
$142.55
|
| Rate for Payer: UHCCP Medicaid |
$90.10
|
|
|
PR PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 99424
|
| Min. Negotiated Rate |
$41.32 |
| Max. Negotiated Rate |
$128.25 |
| Rate for Payer: Aetna Commercial |
$85.99
|
| Rate for Payer: Aetna Medicare |
$64.17
|
| Rate for Payer: BCBS Complete |
$43.39
|
| Rate for Payer: BCBS MAPPO |
$64.17
|
| Rate for Payer: BCN Commercial |
$111.05
|
| Rate for Payer: BCN Medicare Advantage |
$64.17
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Commercial |
$92.40
|
| Rate for Payer: Cofinity Commercial |
$85.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.17
|
| Rate for Payer: Healthscope Commercial |
$70.59
|
| Rate for Payer: Healthscope Whirlpool |
$70.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.38
|
| Rate for Payer: Meridian Medicaid |
$43.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.59
|
| Rate for Payer: Nomi Health Commercial |
$77.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.25
|
| Rate for Payer: PACE SWMI |
$64.17
|
| Rate for Payer: PHP Medicare Advantage |
$64.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$84.54
|
| Rate for Payer: Priority Health Medicare |
$64.17
|
| Rate for Payer: Priority Health Narrow Network |
$84.54
|
| Rate for Payer: Railroad Medicare Medicare |
$64.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$64.17
|
| Rate for Payer: UHC Exchange |
$108.97
|
| Rate for Payer: UHC Medicaid |
$41.32
|
| Rate for Payer: UHCCP DNSP |
$64.17
|
| Rate for Payer: UHCCP Medicaid |
$41.32
|
|
|
PR PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 99426
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: Aetna Medicare |
$43.66
|
| Rate for Payer: BCBS Complete |
$29.53
|
| Rate for Payer: BCBS MAPPO |
$43.66
|
| Rate for Payer: BCN Commercial |
$73.20
|
| Rate for Payer: BCN Medicare Advantage |
$43.66
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$62.87
|
| Rate for Payer: Cofinity Commercial |
$58.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$48.03
|
| Rate for Payer: Healthscope Whirlpool |
$48.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.84
|
| Rate for Payer: Meridian Medicaid |
$29.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.03
|
| Rate for Payer: Nomi Health Commercial |
$52.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PACE SWMI |
$43.66
|
| Rate for Payer: PHP Medicare Advantage |
$43.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.72
|
| Rate for Payer: Priority Health Medicare |
$43.66
|
| Rate for Payer: Priority Health Narrow Network |
$55.72
|
| Rate for Payer: Railroad Medicare Medicare |
$43.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.66
|
| Rate for Payer: UHC Exchange |
$73.16
|
| Rate for Payer: UHC Medicaid |
$28.12
|
| Rate for Payer: UHCCP DNSP |
$43.66
|
| Rate for Payer: UHCCP Medicaid |
$28.12
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 99427
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$41.66
|
| Rate for Payer: Aetna Medicare |
$31.09
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS MAPPO |
$31.09
|
| Rate for Payer: BCN Commercial |
$52.79
|
| Rate for Payer: BCN Medicare Advantage |
$31.09
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$44.77
|
| Rate for Payer: Cofinity Commercial |
$41.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.09
|
| Rate for Payer: Healthscope Commercial |
$34.20
|
| Rate for Payer: Healthscope Whirlpool |
$34.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.64
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.20
|
| Rate for Payer: Nomi Health Commercial |
$37.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PACE SWMI |
$31.09
|
| Rate for Payer: PHP Medicare Advantage |
$31.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$40.18
|
| Rate for Payer: Priority Health Medicare |
$31.09
|
| Rate for Payer: Priority Health Narrow Network |
$40.18
|
| Rate for Payer: Railroad Medicare Medicare |
$31.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.09
|
| Rate for Payer: UHC Exchange |
$51.60
|
| Rate for Payer: UHC Medicaid |
$20.02
|
| Rate for Payer: UHCCP DNSP |
$31.09
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 99425
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: Aetna Medicare |
$43.66
|
| Rate for Payer: BCBS Complete |
$29.53
|
| Rate for Payer: BCBS MAPPO |
$43.66
|
| Rate for Payer: BCN Commercial |
$75.70
|
| Rate for Payer: BCN Medicare Advantage |
$43.66
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$62.87
|
| Rate for Payer: Cofinity Commercial |
$58.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$48.03
|
| Rate for Payer: Healthscope Whirlpool |
$48.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.84
|
| Rate for Payer: Meridian Medicaid |
$29.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.03
|
| Rate for Payer: Nomi Health Commercial |
$52.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.00
|
| Rate for Payer: PACE SWMI |
$43.66
|
| Rate for Payer: PHP Medicare Advantage |
$43.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$57.62
|
| Rate for Payer: Priority Health Medicare |
$43.66
|
| Rate for Payer: Priority Health Narrow Network |
$57.62
|
| Rate for Payer: Railroad Medicare Medicare |
$43.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.66
|
| Rate for Payer: UHC Exchange |
$75.97
|
| Rate for Payer: UHC Medicaid |
$28.12
|
| Rate for Payer: UHCCP DNSP |
$43.66
|
| Rate for Payer: UHCCP Medicaid |
$28.12
|
|
|
PR PROBE NASOLACRIMAL DUCT W/WO IRRIGATION
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 68810
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$223.41 |
| Rate for Payer: Aetna Commercial |
$144.30
|
| Rate for Payer: Aetna Medicare |
$107.69
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$107.69
|
| Rate for Payer: BCN Commercial |
$150.40
|
| Rate for Payer: BCN Medicare Advantage |
$107.69
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$155.07
|
| Rate for Payer: Cofinity Commercial |
$144.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.69
|
| Rate for Payer: Healthscope Commercial |
$129.23
|
| Rate for Payer: Healthscope Whirlpool |
$129.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.07
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.46
|
| Rate for Payer: Nomi Health Commercial |
$129.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.75
|
| Rate for Payer: PACE SWMI |
$107.69
|
| Rate for Payer: PHP Medicare Advantage |
$107.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$223.41
|
| Rate for Payer: Priority Health Medicare |
$107.69
|
| Rate for Payer: Priority Health Narrow Network |
$223.41
|
| Rate for Payer: Railroad Medicare Medicare |
$107.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.69
|
| Rate for Payer: UHC Exchange |
$215.66
|
| Rate for Payer: UHC Medicaid |
$71.57
|
| Rate for Payer: UHCCP DNSP |
$107.69
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
|
|
PR PROCHLORPERAZINE INJECTION
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS J0780
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna Medicare |
$3.33
|
| Rate for Payer: BCBS MAPPO |
$3.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.60
|
| Rate for Payer: BCN Commercial |
$1.77
|
| Rate for Payer: BCN Medicare Advantage |
$3.33
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$4.46
|
| Rate for Payer: Cofinity Commercial |
$4.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$4.00
|
| Rate for Payer: Healthscope Whirlpool |
$4.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.66
|
| Rate for Payer: Nomi Health Commercial |
$4.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$3.33
|
| Rate for Payer: PHP Medicare Advantage |
$3.33
|
| Rate for Payer: Priority Health Medicare |
$3.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.33
|
| Rate for Payer: UHC Exchange |
$2.52
|
| Rate for Payer: UHCCP DNSP |
$3.33
|
|
|
PR PROCTOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$3,174.00
|
|
|
Service Code
|
HCPCS 45540
|
| Min. Negotiated Rate |
$621.32 |
| Max. Negotiated Rate |
$2,380.50 |
| Rate for Payer: Aetna Commercial |
$1,291.53
|
| Rate for Payer: Aetna Medicare |
$963.83
|
| Rate for Payer: BCBS Complete |
$652.39
|
| Rate for Payer: BCBS MAPPO |
$963.83
|
| Rate for Payer: BCN Commercial |
$1,568.14
|
| Rate for Payer: BCN Medicare Advantage |
$963.83
|
| Rate for Payer: Cash Price |
$2,539.20
|
| Rate for Payer: Cash Price |
$2,539.20
|
| Rate for Payer: Cofinity Commercial |
$1,387.92
|
| Rate for Payer: Cofinity Commercial |
$1,291.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$963.83
|
| Rate for Payer: Healthscope Commercial |
$1,156.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,156.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,012.02
|
| Rate for Payer: Meridian Medicaid |
$652.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,060.21
|
| Rate for Payer: Nomi Health Commercial |
$1,156.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,380.50
|
| Rate for Payer: PACE SWMI |
$963.83
|
| Rate for Payer: PHP Medicare Advantage |
$963.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,910.68
|
| Rate for Payer: Priority Health Medicare |
$963.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,910.68
|
| Rate for Payer: Railroad Medicare Medicare |
$963.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,874.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$963.83
|
| Rate for Payer: UHC Exchange |
$1,874.54
|
| Rate for Payer: UHC Medicaid |
$621.32
|
| Rate for Payer: UHCCP DNSP |
$963.83
|
| Rate for Payer: UHCCP Medicaid |
$621.32
|
|
|
PR PROCTOPEXY PERINEAL APPROACH
|
Professional
|
Both
|
$1,708.00
|
|
|
Service Code
|
HCPCS 45541
|
| Min. Negotiated Rate |
$568.07 |
| Max. Negotiated Rate |
$1,718.95 |
| Rate for Payer: Aetna Commercial |
$1,174.54
|
| Rate for Payer: Aetna Medicare |
$876.52
|
| Rate for Payer: BCBS Complete |
$596.47
|
| Rate for Payer: BCBS MAPPO |
$876.52
|
| Rate for Payer: BCN Commercial |
$1,410.78
|
| Rate for Payer: BCN Medicare Advantage |
$876.52
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cofinity Commercial |
$1,262.19
|
| Rate for Payer: Cofinity Commercial |
$1,174.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$876.52
|
| Rate for Payer: Healthscope Commercial |
$1,051.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,051.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$920.35
|
| Rate for Payer: Meridian Medicaid |
$596.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$964.17
|
| Rate for Payer: Nomi Health Commercial |
$1,051.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,281.00
|
| Rate for Payer: PACE SWMI |
$876.52
|
| Rate for Payer: PHP Medicare Advantage |
$876.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$568.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,718.95
|
| Rate for Payer: Priority Health Medicare |
$876.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,718.95
|
| Rate for Payer: Railroad Medicare Medicare |
$876.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,665.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$876.52
|
| Rate for Payer: UHC Exchange |
$1,665.62
|
| Rate for Payer: UHC Medicaid |
$568.07
|
| Rate for Payer: UHCCP DNSP |
$876.52
|
| Rate for Payer: UHCCP Medicaid |
$568.07
|
|
|
PR PROCTOPEXY W/SIGMOID RESCJ ABDL APPR
|
Professional
|
Both
|
$3,801.00
|
|
|
Service Code
|
HCPCS 45550
|
| Min. Negotiated Rate |
$862.44 |
| Max. Negotiated Rate |
$2,850.75 |
| Rate for Payer: Aetna Commercial |
$1,792.99
|
| Rate for Payer: Aetna Medicare |
$1,338.05
|
| Rate for Payer: BCBS Complete |
$905.56
|
| Rate for Payer: BCBS MAPPO |
$1,338.05
|
| Rate for Payer: BCN Commercial |
$2,168.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,338.05
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cofinity Commercial |
$1,926.79
|
| Rate for Payer: Cofinity Commercial |
$1,792.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,338.05
|
| Rate for Payer: Healthscope Commercial |
$1,605.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,605.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,404.95
|
| Rate for Payer: Meridian Medicaid |
$905.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,471.86
|
| Rate for Payer: Nomi Health Commercial |
$1,605.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,850.75
|
| Rate for Payer: PACE SWMI |
$1,338.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,338.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$862.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,642.43
|
| Rate for Payer: Priority Health Medicare |
$1,338.05
|
| Rate for Payer: Priority Health Narrow Network |
$2,642.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,338.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,590.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,338.05
|
| Rate for Payer: UHC Exchange |
$2,590.56
|
| Rate for Payer: UHC Medicaid |
$862.44
|
| Rate for Payer: UHCCP DNSP |
$1,338.05
|
| Rate for Payer: UHCCP Medicaid |
$862.44
|
|
|
PR PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE
|
Professional
|
Both
|
$1,738.00
|
|
|
Service Code
|
HCPCS 45505
|
| Min. Negotiated Rate |
$378.93 |
| Max. Negotiated Rate |
$1,303.50 |
| Rate for Payer: Aetna Commercial |
$772.80
|
| Rate for Payer: Aetna Medicare |
$576.72
|
| Rate for Payer: BCBS Complete |
$397.88
|
| Rate for Payer: BCBS MAPPO |
$576.72
|
| Rate for Payer: BCN Commercial |
$909.81
|
| Rate for Payer: BCN Medicare Advantage |
$576.72
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cofinity Commercial |
$830.48
|
| Rate for Payer: Cofinity Commercial |
$772.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$576.72
|
| Rate for Payer: Healthscope Commercial |
$692.06
|
| Rate for Payer: Healthscope Whirlpool |
$692.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$605.56
|
| Rate for Payer: Meridian Medicaid |
$397.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$634.39
|
| Rate for Payer: Nomi Health Commercial |
$692.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,303.50
|
| Rate for Payer: PACE SWMI |
$576.72
|
| Rate for Payer: PHP Medicare Advantage |
$576.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,108.54
|
| Rate for Payer: Priority Health Medicare |
$576.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,108.54
|
| Rate for Payer: Railroad Medicare Medicare |
$576.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,042.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$576.72
|
| Rate for Payer: UHC Exchange |
$1,042.75
|
| Rate for Payer: UHC Medicaid |
$378.93
|
| Rate for Payer: UHCCP DNSP |
$576.72
|
| Rate for Payer: UHCCP Medicaid |
$378.93
|
|
|
PR PROCTOPLASTY STENOSIS
|
Professional
|
Both
|
$1,174.00
|
|
|
Service Code
|
HCPCS 45500
|
| Min. Negotiated Rate |
$363.59 |
| Max. Negotiated Rate |
$1,054.54 |
| Rate for Payer: Aetna Commercial |
$746.33
|
| Rate for Payer: Aetna Medicare |
$556.96
|
| Rate for Payer: BCBS Complete |
$381.77
|
| Rate for Payer: BCBS MAPPO |
$556.96
|
| Rate for Payer: BCN Commercial |
$865.49
|
| Rate for Payer: BCN Medicare Advantage |
$556.96
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cofinity Commercial |
$802.02
|
| Rate for Payer: Cofinity Commercial |
$746.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$556.96
|
| Rate for Payer: Healthscope Commercial |
$668.35
|
| Rate for Payer: Healthscope Whirlpool |
$668.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$584.81
|
| Rate for Payer: Meridian Medicaid |
$381.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$612.66
|
| Rate for Payer: Nomi Health Commercial |
$668.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$880.50
|
| Rate for Payer: PACE SWMI |
$556.96
|
| Rate for Payer: PHP Medicare Advantage |
$556.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,054.54
|
| Rate for Payer: Priority Health Medicare |
$556.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,054.54
|
| Rate for Payer: Railroad Medicare Medicare |
$556.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$991.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$556.96
|
| Rate for Payer: UHC Exchange |
$991.77
|
| Rate for Payer: UHC Medicaid |
$363.59
|
| Rate for Payer: UHCCP DNSP |
$556.96
|
| Rate for Payer: UHCCP Medicaid |
$363.59
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$142.30 |
| Max. Negotiated Rate |
$1,158.26 |
| Rate for Payer: Aetna Commercial |
$182.70
|
| Rate for Payer: Aetna Medicare |
$926.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,158.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,158.26
|
| Rate for Payer: ASR ASR |
$196.91
|
| Rate for Payer: BCBS Complete |
$508.89
|
| Rate for Payer: BCBS MAPPO |
$926.61
|
| Rate for Payer: BCBS Trust/PPO |
$167.37
|
| Rate for Payer: BCN Commercial |
$167.37
|
| Rate for Payer: BCN Medicare Advantage |
$926.61
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$190.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.61
|
| Rate for Payer: Healthscope Commercial |
$196.91
|
| Rate for Payer: Healthscope Whirlpool |
$203.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$926.61
|
| Rate for Payer: Mclaren Commercial |
$182.70
|
| Rate for Payer: Mclaren Medicaid |
$926.61
|
| Rate for Payer: Mclaren Medicare |
$926.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.94
|
| Rate for Payer: Meridian Medicaid |
$508.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,065.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,019.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.55
|
| Rate for Payer: Nomi Health Commercial |
$166.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
| Rate for Payer: PACE Medicare |
$880.28
|
| Rate for Payer: PACE SWMI |
$926.61
|
| Rate for Payer: PHP Commercial |
$1,019.27
|
| Rate for Payer: PHP Medicaid |
$496.66
|
| Rate for Payer: PHP Medicare Advantage |
$926.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$177.87
|
| Rate for Payer: Priority Health Medicare |
$926.61
|
| Rate for Payer: Priority Health Narrow Network |
$142.30
|
| Rate for Payer: Railroad Medicare Medicare |
$926.61
|
| Rate for Payer: UHC Medicaid |
$484.62
|
| Rate for Payer: UHCCP DNSP |
$926.61
|
| Rate for Payer: UHCCP Medicaid |
$484.62
|
| Rate for Payer: VA VA |
$926.61
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$152.25 |
| Max. Negotiated Rate |
$203.00 |
| Rate for Payer: Aetna Commercial |
$182.70
|
| Rate for Payer: ASR ASR |
$196.91
|
| Rate for Payer: BCBS Trust/PPO |
$166.70
|
| Rate for Payer: BCN Commercial |
$166.70
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$190.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.40
|
| Rate for Payer: Healthscope Commercial |
$196.91
|
| Rate for Payer: Healthscope Whirlpool |
$203.00
|
| Rate for Payer: Mclaren Commercial |
$182.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.55
|
| Rate for Payer: Nomi Health Commercial |
$166.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 45300
|
| Hospital Charge Code |
45300
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$152.25 |
| Rate for Payer: Aetna Commercial |
$59.46
|
| Rate for Payer: Aetna Medicare |
$44.37
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS MAPPO |
$44.37
|
| Rate for Payer: BCN Commercial |
$57.33
|
| Rate for Payer: BCN Medicare Advantage |
$44.37
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Cofinity Commercial |
$59.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.37
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Healthscope Whirlpool |
$53.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.59
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.81
|
| Rate for Payer: Nomi Health Commercial |
$53.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
| Rate for Payer: PACE SWMI |
$44.37
|
| Rate for Payer: PHP Medicare Advantage |
$44.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.59
|
| Rate for Payer: Priority Health Medicare |
$44.37
|
| Rate for Payer: Priority Health Narrow Network |
$88.59
|
| Rate for Payer: Railroad Medicare Medicare |
$44.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.37
|
| Rate for Payer: UHC Exchange |
$84.15
|
| Rate for Payer: UHC Medicaid |
$28.76
|
| Rate for Payer: UHCCP DNSP |
$44.37
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 45300
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$152.25 |
| Rate for Payer: Aetna Commercial |
$59.46
|
| Rate for Payer: Aetna Medicare |
$44.37
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS MAPPO |
$44.37
|
| Rate for Payer: BCN Commercial |
$57.33
|
| Rate for Payer: BCN Medicare Advantage |
$44.37
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Cofinity Commercial |
$59.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.37
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Healthscope Whirlpool |
$53.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.59
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.81
|
| Rate for Payer: Nomi Health Commercial |
$53.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
| Rate for Payer: PACE SWMI |
$44.37
|
| Rate for Payer: PHP Medicare Advantage |
$44.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.59
|
| Rate for Payer: Priority Health Medicare |
$44.37
|
| Rate for Payer: Priority Health Narrow Network |
$88.59
|
| Rate for Payer: Railroad Medicare Medicare |
$44.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.37
|
| Rate for Payer: UHC Exchange |
$84.15
|
| Rate for Payer: UHC Medicaid |
$28.76
|
| Rate for Payer: UHCCP DNSP |
$44.37
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
|
|
PR PROCTOSGMDSC RIGID ABLATION LESION
|
Professional
|
Both
|
$496.00
|
|
|
Service Code
|
HCPCS 45320
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$372.00 |
| Rate for Payer: Aetna Commercial |
$132.31
|
| Rate for Payer: Aetna Medicare |
$98.74
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$98.74
|
| Rate for Payer: BCN Commercial |
$158.86
|
| Rate for Payer: BCN Medicare Advantage |
$98.74
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cofinity Commercial |
$142.19
|
| Rate for Payer: Cofinity Commercial |
$132.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.74
|
| Rate for Payer: Healthscope Commercial |
$118.49
|
| Rate for Payer: Healthscope Whirlpool |
$118.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.68
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.61
|
| Rate for Payer: Nomi Health Commercial |
$118.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.00
|
| Rate for Payer: PACE SWMI |
$98.74
|
| Rate for Payer: PHP Medicare Advantage |
$98.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$193.56
|
| Rate for Payer: Priority Health Medicare |
$98.74
|
| Rate for Payer: Priority Health Narrow Network |
$193.56
|
| Rate for Payer: Railroad Medicare Medicare |
$98.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.74
|
| Rate for Payer: UHC Exchange |
$186.37
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP DNSP |
$98.74
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR PROCTOSGMDSC RIGID CONTROL BLEEDING
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 45317
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$349.50 |
| Rate for Payer: Aetna Commercial |
$135.55
|
| Rate for Payer: Aetna Medicare |
$101.16
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$101.16
|
| Rate for Payer: BCN Commercial |
$165.33
|
| Rate for Payer: BCN Medicare Advantage |
$101.16
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cofinity Commercial |
$145.67
|
| Rate for Payer: Cofinity Commercial |
$135.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.16
|
| Rate for Payer: Healthscope Commercial |
$121.39
|
| Rate for Payer: Healthscope Whirlpool |
$121.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.22
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.28
|
| Rate for Payer: Nomi Health Commercial |
$121.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$349.50
|
| Rate for Payer: PACE SWMI |
$101.16
|
| Rate for Payer: PHP Medicare Advantage |
$101.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$201.44
|
| Rate for Payer: Priority Health Medicare |
$101.16
|
| Rate for Payer: Priority Health Narrow Network |
$201.44
|
| Rate for Payer: Railroad Medicare Medicare |
$101.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.16
|
| Rate for Payer: UHC Exchange |
$196.06
|
| Rate for Payer: UHC Medicaid |
$65.39
|
| Rate for Payer: UHCCP DNSP |
$101.16
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
|
|
PR PROCTOSGMDSC RIGID DCMPRN VOLVULUS
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 45321
|
| Min. Negotiated Rate |
$62.62 |
| Max. Negotiated Rate |
$303.00 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: Aetna Medicare |
$97.44
|
| Rate for Payer: BCBS Complete |
$65.75
|
| Rate for Payer: BCBS MAPPO |
$97.44
|
| Rate for Payer: BCN Commercial |
$156.37
|
| Rate for Payer: BCN Medicare Advantage |
$97.44
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$140.31
|
| Rate for Payer: Cofinity Commercial |
$130.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.44
|
| Rate for Payer: Healthscope Commercial |
$116.93
|
| Rate for Payer: Healthscope Whirlpool |
$116.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.31
|
| Rate for Payer: Meridian Medicaid |
$65.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.18
|
| Rate for Payer: Nomi Health Commercial |
$116.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.00
|
| Rate for Payer: PACE SWMI |
$97.44
|
| Rate for Payer: PHP Medicare Advantage |
$97.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$190.53
|
| Rate for Payer: Priority Health Medicare |
$97.44
|
| Rate for Payer: Priority Health Narrow Network |
$190.53
|
| Rate for Payer: Railroad Medicare Medicare |
$97.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.44
|
| Rate for Payer: UHC Exchange |
$183.92
|
| Rate for Payer: UHC Medicaid |
$62.62
|
| Rate for Payer: UHCCP DNSP |
$97.44
|
| Rate for Payer: UHCCP Medicaid |
$62.62
|
|
