|
PR PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 45308
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Aetna Commercial |
$108.03
|
| Rate for Payer: Aetna Medicare |
$80.62
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$80.62
|
| Rate for Payer: BCN Commercial |
$127.49
|
| Rate for Payer: BCN Medicare Advantage |
$80.62
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cofinity Commercial |
$116.09
|
| Rate for Payer: Cofinity Commercial |
$108.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.62
|
| Rate for Payer: Healthscope Commercial |
$96.74
|
| Rate for Payer: Healthscope Whirlpool |
$96.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.65
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.68
|
| Rate for Payer: Nomi Health Commercial |
$96.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.00
|
| Rate for Payer: PACE SWMI |
$80.62
|
| Rate for Payer: PHP Medicare Advantage |
$80.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$155.34
|
| Rate for Payer: Priority Health Medicare |
$80.62
|
| Rate for Payer: Priority Health Narrow Network |
$155.34
|
| Rate for Payer: Railroad Medicare Medicare |
$80.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.62
|
| Rate for Payer: UHC Exchange |
$148.82
|
| Rate for Payer: UHC Medicaid |
$51.97
|
| Rate for Payer: UHCCP DNSP |
$80.62
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 45309
|
| Min. Negotiated Rate |
$54.95 |
| Max. Negotiated Rate |
$291.00 |
| Rate for Payer: Aetna Commercial |
$114.34
|
| Rate for Payer: Aetna Medicare |
$85.33
|
| Rate for Payer: BCBS Complete |
$57.70
|
| Rate for Payer: BCBS MAPPO |
$85.33
|
| Rate for Payer: BCN Commercial |
$135.45
|
| Rate for Payer: BCN Medicare Advantage |
$85.33
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cofinity Commercial |
$122.88
|
| Rate for Payer: Cofinity Commercial |
$114.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.33
|
| Rate for Payer: Healthscope Commercial |
$102.40
|
| Rate for Payer: Healthscope Whirlpool |
$102.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.60
|
| Rate for Payer: Meridian Medicaid |
$57.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.86
|
| Rate for Payer: Nomi Health Commercial |
$102.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.00
|
| Rate for Payer: PACE SWMI |
$85.33
|
| Rate for Payer: PHP Medicare Advantage |
$85.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$165.03
|
| Rate for Payer: Priority Health Medicare |
$85.33
|
| Rate for Payer: Priority Health Narrow Network |
$165.03
|
| Rate for Payer: Railroad Medicare Medicare |
$85.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.33
|
| Rate for Payer: UHC Exchange |
$158.65
|
| Rate for Payer: UHC Medicaid |
$54.95
|
| Rate for Payer: UHCCP DNSP |
$85.33
|
| Rate for Payer: UHCCP Medicaid |
$54.95
|
|
|
PR PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE
|
Professional
|
Both
|
$496.00
|
|
|
Service Code
|
HCPCS 45315
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$372.00 |
| Rate for Payer: Aetna Commercial |
$133.21
|
| Rate for Payer: Aetna Medicare |
$99.41
|
| Rate for Payer: BCBS Complete |
$67.09
|
| Rate for Payer: BCBS MAPPO |
$99.41
|
| Rate for Payer: BCN Commercial |
$159.85
|
| Rate for Payer: BCN Medicare Advantage |
$99.41
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cofinity Commercial |
$143.15
|
| Rate for Payer: Cofinity Commercial |
$133.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.41
|
| Rate for Payer: Healthscope Commercial |
$119.29
|
| Rate for Payer: Healthscope Whirlpool |
$119.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.38
|
| Rate for Payer: Meridian Medicaid |
$67.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.35
|
| Rate for Payer: Nomi Health Commercial |
$119.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.00
|
| Rate for Payer: PACE SWMI |
$99.41
|
| Rate for Payer: PHP Medicare Advantage |
$99.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$194.76
|
| Rate for Payer: Priority Health Medicare |
$99.41
|
| Rate for Payer: Priority Health Narrow Network |
$194.76
|
| Rate for Payer: Railroad Medicare Medicare |
$99.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.41
|
| Rate for Payer: UHC Exchange |
$188.27
|
| Rate for Payer: UHC Medicaid |
$63.90
|
| Rate for Payer: UHCCP DNSP |
$99.41
|
| Rate for Payer: UHCCP Medicaid |
$63.90
|
|
|
PR PROCTOSGMDSC RIGID TNDSC STENT PLMT
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 45327
|
| Min. Negotiated Rate |
$70.08 |
| Max. Negotiated Rate |
$215.40 |
| Rate for Payer: Aetna Commercial |
$146.29
|
| Rate for Payer: Aetna Medicare |
$109.17
|
| Rate for Payer: BCBS Complete |
$73.58
|
| Rate for Payer: BCBS MAPPO |
$109.17
|
| Rate for Payer: BCN Commercial |
$176.78
|
| Rate for Payer: BCN Medicare Advantage |
$109.17
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$157.20
|
| Rate for Payer: Cofinity Commercial |
$146.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.17
|
| Rate for Payer: Healthscope Commercial |
$131.00
|
| Rate for Payer: Healthscope Whirlpool |
$131.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.63
|
| Rate for Payer: Meridian Medicaid |
$73.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.09
|
| Rate for Payer: Nomi Health Commercial |
$131.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.25
|
| Rate for Payer: PACE SWMI |
$109.17
|
| Rate for Payer: PHP Medicare Advantage |
$109.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$215.40
|
| Rate for Payer: Priority Health Medicare |
$109.17
|
| Rate for Payer: Priority Health Narrow Network |
$215.40
|
| Rate for Payer: Railroad Medicare Medicare |
$109.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$208.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.17
|
| Rate for Payer: UHC Exchange |
$208.56
|
| Rate for Payer: UHC Medicaid |
$70.08
|
| Rate for Payer: UHCCP DNSP |
$109.17
|
| Rate for Payer: UHCCP Medicaid |
$70.08
|
|
|
PR PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 45305
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$90.88
|
| Rate for Payer: Aetna Medicare |
$67.82
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$67.82
|
| Rate for Payer: BCN Commercial |
$109.55
|
| Rate for Payer: BCN Medicare Advantage |
$67.82
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$97.66
|
| Rate for Payer: Cofinity Commercial |
$90.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.82
|
| Rate for Payer: Healthscope Commercial |
$81.38
|
| Rate for Payer: Healthscope Whirlpool |
$81.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.21
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.60
|
| Rate for Payer: Nomi Health Commercial |
$81.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.50
|
| Rate for Payer: PACE SWMI |
$67.82
|
| Rate for Payer: PHP Medicare Advantage |
$67.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$133.48
|
| Rate for Payer: Priority Health Medicare |
$67.82
|
| Rate for Payer: Priority Health Narrow Network |
$133.48
|
| Rate for Payer: Railroad Medicare Medicare |
$67.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$67.82
|
| Rate for Payer: UHC Exchange |
$127.80
|
| Rate for Payer: UHC Medicaid |
$44.09
|
| Rate for Payer: UHCCP DNSP |
$67.82
|
| Rate for Payer: UHCCP Medicaid |
$44.09
|
|
|
PR PROCTOSGMDSC RIGID W/DILATION
|
Professional
|
Both
|
$214.00
|
|
|
Service Code
|
HCPCS 45303
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$160.50 |
| Rate for Payer: Aetna Commercial |
$105.63
|
| Rate for Payer: Aetna Medicare |
$78.83
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCBS MAPPO |
$78.83
|
| Rate for Payer: BCN Commercial |
$127.49
|
| Rate for Payer: BCN Medicare Advantage |
$78.83
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cofinity Commercial |
$113.52
|
| Rate for Payer: Cofinity Commercial |
$105.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.83
|
| Rate for Payer: Healthscope Commercial |
$94.60
|
| Rate for Payer: Healthscope Whirlpool |
$94.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.77
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.71
|
| Rate for Payer: Nomi Health Commercial |
$94.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.50
|
| Rate for Payer: PACE SWMI |
$78.83
|
| Rate for Payer: PHP Medicare Advantage |
$78.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$155.34
|
| Rate for Payer: Priority Health Medicare |
$78.83
|
| Rate for Payer: Priority Health Narrow Network |
$155.34
|
| Rate for Payer: Railroad Medicare Medicare |
$78.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.83
|
| Rate for Payer: UHC Exchange |
$149.36
|
| Rate for Payer: UHC Medicaid |
$51.12
|
| Rate for Payer: UHCCP DNSP |
$78.83
|
| Rate for Payer: UHCCP Medicaid |
$51.12
|
|
|
PR PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 45307
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$261.75 |
| Rate for Payer: Aetna Commercial |
$127.41
|
| Rate for Payer: Aetna Medicare |
$95.08
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$95.08
|
| Rate for Payer: BCN Commercial |
$151.39
|
| Rate for Payer: BCN Medicare Advantage |
$95.08
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cofinity Commercial |
$136.92
|
| Rate for Payer: Cofinity Commercial |
$127.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.08
|
| Rate for Payer: Healthscope Commercial |
$114.10
|
| Rate for Payer: Healthscope Whirlpool |
$114.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.83
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.59
|
| Rate for Payer: Nomi Health Commercial |
$114.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.75
|
| Rate for Payer: PACE SWMI |
$95.08
|
| Rate for Payer: PHP Medicare Advantage |
$95.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$184.45
|
| Rate for Payer: Priority Health Medicare |
$95.08
|
| Rate for Payer: Priority Health Narrow Network |
$184.45
|
| Rate for Payer: Railroad Medicare Medicare |
$95.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.08
|
| Rate for Payer: UHC Exchange |
$171.37
|
| Rate for Payer: UHC Medicaid |
$61.13
|
| Rate for Payer: UHCCP DNSP |
$95.08
|
| Rate for Payer: UHCCP Medicaid |
$61.13
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 95115
|
| Min. Negotiated Rate |
$9.53 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Aetna Commercial |
$12.77
|
| Rate for Payer: Aetna Medicare |
$9.53
|
| Rate for Payer: BCBS MAPPO |
$9.53
|
| Rate for Payer: BCN Commercial |
$15.93
|
| Rate for Payer: BCN Medicare Advantage |
$9.53
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$12.77
|
| Rate for Payer: Cofinity Commercial |
$13.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.53
|
| Rate for Payer: Healthscope Commercial |
$11.44
|
| Rate for Payer: Healthscope Whirlpool |
$11.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.48
|
| Rate for Payer: Nomi Health Commercial |
$11.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PACE SWMI |
$9.53
|
| Rate for Payer: PHP Medicare Advantage |
$9.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13.72
|
| Rate for Payer: Priority Health Medicare |
$9.53
|
| Rate for Payer: Priority Health Narrow Network |
$13.72
|
| Rate for Payer: Railroad Medicare Medicare |
$9.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.53
|
| Rate for Payer: UHC Exchange |
$13.88
|
| Rate for Payer: UHCCP DNSP |
$9.53
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 95117
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$24.75 |
| Rate for Payer: Aetna Commercial |
$15.22
|
| Rate for Payer: Aetna Medicare |
$11.36
|
| Rate for Payer: BCBS MAPPO |
$11.36
|
| Rate for Payer: BCN Commercial |
$18.43
|
| Rate for Payer: BCN Medicare Advantage |
$11.36
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$15.22
|
| Rate for Payer: Cofinity Commercial |
$16.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.36
|
| Rate for Payer: Healthscope Commercial |
$13.63
|
| Rate for Payer: Healthscope Whirlpool |
$13.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.50
|
| Rate for Payer: Nomi Health Commercial |
$13.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: PACE SWMI |
$11.36
|
| Rate for Payer: PHP Medicare Advantage |
$11.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16.65
|
| Rate for Payer: Priority Health Medicare |
$11.36
|
| Rate for Payer: Priority Health Narrow Network |
$16.65
|
| Rate for Payer: Railroad Medicare Medicare |
$11.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.36
|
| Rate for Payer: UHC Exchange |
$16.00
|
| Rate for Payer: UHCCP DNSP |
$11.36
|
|
|
PR PROG DEVICE EVAL IN PERSON LEADLESS PM SYSTEM
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 0389T
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 93280
|
| Min. Negotiated Rate |
$74.13 |
| Max. Negotiated Rate |
$170.25 |
| Rate for Payer: Aetna Commercial |
$99.33
|
| Rate for Payer: Aetna Medicare |
$74.13
|
| Rate for Payer: BCBS MAPPO |
$74.13
|
| Rate for Payer: BCN Commercial |
$115.53
|
| Rate for Payer: BCN Medicare Advantage |
$74.13
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$99.33
|
| Rate for Payer: Cofinity Commercial |
$106.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.13
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Healthscope Whirlpool |
$88.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.54
|
| Rate for Payer: Nomi Health Commercial |
$88.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.25
|
| Rate for Payer: PACE SWMI |
$74.13
|
| Rate for Payer: PHP Medicare Advantage |
$74.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$109.80
|
| Rate for Payer: Priority Health Medicare |
$74.13
|
| Rate for Payer: Priority Health Narrow Network |
$109.80
|
| Rate for Payer: Railroad Medicare Medicare |
$74.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.13
|
| Rate for Payer: UHC Exchange |
$111.93
|
| Rate for Payer: UHCCP DNSP |
$74.13
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 93281
|
| Min. Negotiated Rate |
$78.33 |
| Max. Negotiated Rate |
$177.75 |
| Rate for Payer: Aetna Commercial |
$104.96
|
| Rate for Payer: Aetna Medicare |
$78.33
|
| Rate for Payer: BCBS MAPPO |
$78.33
|
| Rate for Payer: BCN Commercial |
$123.00
|
| Rate for Payer: BCN Medicare Advantage |
$78.33
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$104.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.33
|
| Rate for Payer: Healthscope Commercial |
$94.00
|
| Rate for Payer: Healthscope Whirlpool |
$94.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.16
|
| Rate for Payer: Nomi Health Commercial |
$94.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.75
|
| Rate for Payer: PACE SWMI |
$78.33
|
| Rate for Payer: PHP Medicare Advantage |
$78.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$116.91
|
| Rate for Payer: Priority Health Medicare |
$78.33
|
| Rate for Payer: Priority Health Narrow Network |
$116.91
|
| Rate for Payer: Railroad Medicare Medicare |
$78.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.33
|
| Rate for Payer: UHC Exchange |
$119.77
|
| Rate for Payer: UHCCP DNSP |
$78.33
|
|
|
PR PROGRAMMED STIMJ & PACG AFTER IV DRUG INFUSION
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 93623
|
| Min. Negotiated Rate |
$100.82 |
| Max. Negotiated Rate |
$1,619.31 |
| Rate for Payer: Aetna Commercial |
$217.76
|
| Rate for Payer: Aetna Commercial |
$217.76
|
| Rate for Payer: BCN Commercial |
$1,619.31
|
| Rate for Payer: BCN Commercial |
$1,619.31
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$100.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$100.82
|
| Rate for Payer: Priority Health Narrow Network |
$100.82
|
| Rate for Payer: Priority Health Narrow Network |
$100.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$657.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$657.94
|
| Rate for Payer: UHC Exchange |
$657.94
|
| Rate for Payer: UHC Exchange |
$657.94
|
|
|
PR PROGRAMMING DEV EVAL ICDS W/SS ELTRD IN PERSON
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS 0575T
|
| Min. Negotiated Rate |
$34.87 |
| Max. Negotiated Rate |
$90.10 |
| Rate for Payer: Aetna Commercial |
$65.51
|
| Rate for Payer: BCBS Complete |
$39.20
|
| Rate for Payer: BCN Commercial |
$34.87
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.10
|
| Rate for Payer: UHC Exchange |
$90.10
|
|
|
PR PRO HEALTH BACK SCREEN
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000022
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$49.47
|
| Rate for Payer: Healthscope Whirlpool |
$51.00
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
PR PRO HEALTH BACK SCREEN
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000022
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.87 |
| Max. Negotiated Rate |
$209.42 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$18.87
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$42.05
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$42.05
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$49.47
|
| Rate for Payer: Healthscope Whirlpool |
$51.00
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$209.42
|
| Rate for Payer: Priority Health Narrow Network |
$167.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
PR PRO HEALTH FIT FOR DUTY EXAM
|
Facility
|
IP
|
$229.50
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51000038
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$172.12 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$206.55
|
| Rate for Payer: ASR ASR |
$222.62
|
| Rate for Payer: BCBS Trust/PPO |
$188.47
|
| Rate for Payer: BCN Commercial |
$188.47
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$222.62
|
| Rate for Payer: Healthscope Whirlpool |
$229.50
|
| Rate for Payer: Mclaren Commercial |
$206.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.07
|
| Rate for Payer: Nomi Health Commercial |
$188.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.96
|
|
|
PR PRO HEALTH FIT FOR DUTY EXAM
|
Facility
|
OP
|
$229.50
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51000038
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$84.92 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$206.55
|
| Rate for Payer: Aetna Medicare |
$84.92
|
| Rate for Payer: ASR ASR |
$222.62
|
| Rate for Payer: BCBS Complete |
$91.80
|
| Rate for Payer: BCBS Trust/PPO |
$189.22
|
| Rate for Payer: BCN Commercial |
$189.22
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$222.62
|
| Rate for Payer: Healthscope Whirlpool |
$229.50
|
| Rate for Payer: Mclaren Commercial |
$206.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$183.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.07
|
| Rate for Payer: Nomi Health Commercial |
$188.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$201.09
|
| Rate for Payer: Priority Health Narrow Network |
$160.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.96
|
|
|
PR PRO HEALTH LIFT TEST
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000023
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$49.47
|
| Rate for Payer: Healthscope Whirlpool |
$51.00
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
PR PRO HEALTH LIFT TEST
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000023
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.87 |
| Max. Negotiated Rate |
$209.42 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$18.87
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$42.05
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$42.05
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$49.47
|
| Rate for Payer: Healthscope Whirlpool |
$51.00
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$209.42
|
| Rate for Payer: Priority Health Narrow Network |
$167.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
PR PRO HEALTH NURSE VISIT
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.08 |
| Max. Negotiated Rate |
$131.95 |
| Rate for Payer: Aetna Commercial |
$29.38
|
| Rate for Payer: Aetna Medicare |
$12.08
|
| Rate for Payer: ASR ASR |
$31.66
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.91
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$26.91
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$31.66
|
| Rate for Payer: Healthscope Whirlpool |
$32.64
|
| Rate for Payer: Mclaren Commercial |
$29.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: Nomi Health Commercial |
$26.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$131.95
|
| Rate for Payer: Priority Health Narrow Network |
$105.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.72
|
|
|
PR PRO HEALTH NURSE VISIT
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.48 |
| Max. Negotiated Rate |
$32.64 |
| Rate for Payer: Aetna Commercial |
$29.38
|
| Rate for Payer: ASR ASR |
$31.66
|
| Rate for Payer: BCBS Trust/PPO |
$26.80
|
| Rate for Payer: BCN Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$31.66
|
| Rate for Payer: Healthscope Whirlpool |
$32.64
|
| Rate for Payer: Mclaren Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: Nomi Health Commercial |
$26.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.72
|
|
|
PR PRO HEALTH PHYSICAL AGILITY TEST
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000028
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$53.55 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: ASR ASR |
$69.26
|
| Rate for Payer: BCBS Trust/PPO |
$58.63
|
| Rate for Payer: BCN Commercial |
$58.63
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$69.26
|
| Rate for Payer: Healthscope Whirlpool |
$71.40
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
|
|
PR PRO HEALTH PHYSICAL AGILITY TEST
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000028
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$26.42 |
| Max. Negotiated Rate |
$233.65 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: Aetna Medicare |
$26.42
|
| Rate for Payer: ASR ASR |
$69.26
|
| Rate for Payer: BCBS Complete |
$28.56
|
| Rate for Payer: BCBS Trust/PPO |
$58.87
|
| Rate for Payer: BCCCP Commercial |
$87.68
|
| Rate for Payer: BCN Commercial |
$58.87
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$69.26
|
| Rate for Payer: Healthscope Whirlpool |
$71.40
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$233.65
|
| Rate for Payer: Priority Health Narrow Network |
$186.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
|
|
PR PRO HEALTH VISION TESTING
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000018
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.12 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: ASR ASR |
$24.73
|
| Rate for Payer: BCBS Trust/PPO |
$20.94
|
| Rate for Payer: BCN Commercial |
$20.94
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$24.73
|
| Rate for Payer: Healthscope Whirlpool |
$25.50
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
