|
PR PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
HCPCS 96137
|
| Min. Negotiated Rate |
$10.44 |
| Max. Negotiated Rate |
$66.75 |
| Rate for Payer: Aetna Commercial |
$21.82
|
| Rate for Payer: Aetna Medicare |
$16.28
|
| Rate for Payer: BCBS Complete |
$10.96
|
| Rate for Payer: BCBS MAPPO |
$16.28
|
| Rate for Payer: BCN Commercial |
$55.28
|
| Rate for Payer: BCN Medicare Advantage |
$16.28
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$23.44
|
| Rate for Payer: Cofinity Commercial |
$21.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.28
|
| Rate for Payer: Healthscope Commercial |
$19.54
|
| Rate for Payer: Healthscope Whirlpool |
$19.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.09
|
| Rate for Payer: Meridian Medicaid |
$10.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.91
|
| Rate for Payer: Nomi Health Commercial |
$19.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.75
|
| Rate for Payer: PACE SWMI |
$16.28
|
| Rate for Payer: PHP Medicare Advantage |
$16.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$24.33
|
| Rate for Payer: Priority Health Medicare |
$16.28
|
| Rate for Payer: Priority Health Narrow Network |
$24.33
|
| Rate for Payer: Railroad Medicare Medicare |
$16.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.28
|
| Rate for Payer: UHC Exchange |
$31.60
|
| Rate for Payer: UHC Medicaid |
$10.44
|
| Rate for Payer: UHCCP DNSP |
$16.28
|
| Rate for Payer: UHCCP Medicaid |
$10.44
|
|
|
PR PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 96138
|
| Min. Negotiated Rate |
$34.53 |
| Max. Negotiated Rate |
$56.93 |
| Rate for Payer: Aetna Commercial |
$46.27
|
| Rate for Payer: Aetna Medicare |
$34.53
|
| Rate for Payer: BCBS MAPPO |
$34.53
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: BCN Medicare Advantage |
$34.53
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$46.27
|
| Rate for Payer: Cofinity Commercial |
$49.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.53
|
| Rate for Payer: Healthscope Commercial |
$41.44
|
| Rate for Payer: Healthscope Whirlpool |
$41.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.98
|
| Rate for Payer: Nomi Health Commercial |
$41.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
| Rate for Payer: PACE SWMI |
$34.53
|
| Rate for Payer: PHP Medicare Advantage |
$34.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$47.76
|
| Rate for Payer: Priority Health Medicare |
$34.53
|
| Rate for Payer: Priority Health Narrow Network |
$47.76
|
| Rate for Payer: Railroad Medicare Medicare |
$34.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.53
|
| Rate for Payer: UHC Exchange |
$56.93
|
| Rate for Payer: UHCCP DNSP |
$34.53
|
|
|
PR PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 96139
|
| Min. Negotiated Rate |
$32.32 |
| Max. Negotiated Rate |
$56.93 |
| Rate for Payer: Aetna Commercial |
$43.31
|
| Rate for Payer: Aetna Medicare |
$32.32
|
| Rate for Payer: BCBS MAPPO |
$32.32
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: BCN Medicare Advantage |
$32.32
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$43.31
|
| Rate for Payer: Cofinity Commercial |
$46.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.32
|
| Rate for Payer: Healthscope Commercial |
$38.78
|
| Rate for Payer: Healthscope Whirlpool |
$38.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.55
|
| Rate for Payer: Nomi Health Commercial |
$38.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
| Rate for Payer: PACE SWMI |
$32.32
|
| Rate for Payer: PHP Medicare Advantage |
$32.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$47.76
|
| Rate for Payer: Priority Health Medicare |
$32.32
|
| Rate for Payer: Priority Health Narrow Network |
$47.76
|
| Rate for Payer: Railroad Medicare Medicare |
$32.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.32
|
| Rate for Payer: UHC Exchange |
$56.93
|
| Rate for Payer: UHCCP DNSP |
$32.32
|
|
|
PR PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 96136
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$72.75 |
| Rate for Payer: Aetna Commercial |
$28.49
|
| Rate for Payer: Aetna Medicare |
$21.26
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$21.26
|
| Rate for Payer: BCN Commercial |
$62.75
|
| Rate for Payer: BCN Medicare Advantage |
$21.26
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$30.61
|
| Rate for Payer: Cofinity Commercial |
$28.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.26
|
| Rate for Payer: Healthscope Commercial |
$25.51
|
| Rate for Payer: Healthscope Whirlpool |
$25.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.32
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.39
|
| Rate for Payer: Nomi Health Commercial |
$25.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.75
|
| Rate for Payer: PACE SWMI |
$21.26
|
| Rate for Payer: PHP Medicare Advantage |
$21.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$32.14
|
| Rate for Payer: Priority Health Medicare |
$21.26
|
| Rate for Payer: Priority Health Narrow Network |
$32.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.26
|
| Rate for Payer: UHC Exchange |
$40.07
|
| Rate for Payer: UHC Medicaid |
$13.63
|
| Rate for Payer: UHCCP DNSP |
$21.26
|
| Rate for Payer: UHCCP Medicaid |
$13.63
|
|
|
PR PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH
|
Professional
|
Both
|
$2,286.00
|
|
|
Service Code
|
HCPCS 31040
|
| Min. Negotiated Rate |
$460.29 |
| Max. Negotiated Rate |
$1,714.50 |
| Rate for Payer: Aetna Commercial |
$933.99
|
| Rate for Payer: Aetna Medicare |
$697.01
|
| Rate for Payer: BCBS Complete |
$483.30
|
| Rate for Payer: BCBS MAPPO |
$697.01
|
| Rate for Payer: BCN Commercial |
$1,203.12
|
| Rate for Payer: BCN Medicare Advantage |
$697.01
|
| Rate for Payer: Cash Price |
$1,828.80
|
| Rate for Payer: Cash Price |
$1,828.80
|
| Rate for Payer: Cofinity Commercial |
$933.99
|
| Rate for Payer: Cofinity Commercial |
$1,003.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.01
|
| Rate for Payer: Healthscope Commercial |
$836.41
|
| Rate for Payer: Healthscope Whirlpool |
$836.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.86
|
| Rate for Payer: Meridian Medicaid |
$483.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$766.71
|
| Rate for Payer: Nomi Health Commercial |
$836.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,714.50
|
| Rate for Payer: PACE SWMI |
$697.01
|
| Rate for Payer: PHP Medicare Advantage |
$697.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,132.98
|
| Rate for Payer: Priority Health Medicare |
$697.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,132.98
|
| Rate for Payer: Railroad Medicare Medicare |
$697.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,349.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$697.01
|
| Rate for Payer: UHC Exchange |
$1,349.94
|
| Rate for Payer: UHC Medicaid |
$460.29
|
| Rate for Payer: UHCCP DNSP |
$697.01
|
| Rate for Payer: UHCCP Medicaid |
$460.29
|
|
|
PR PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 96160
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Commercial |
$3.67
|
| Rate for Payer: Aetna Medicare |
$2.74
|
| Rate for Payer: BCBS MAPPO |
$2.74
|
| Rate for Payer: BCN Commercial |
$4.48
|
| Rate for Payer: BCN Medicare Advantage |
$2.74
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.74
|
| Rate for Payer: Healthscope Commercial |
$3.29
|
| Rate for Payer: Healthscope Whirlpool |
$3.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.01
|
| Rate for Payer: Nomi Health Commercial |
$3.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PACE SWMI |
$2.74
|
| Rate for Payer: PHP Medicare Advantage |
$2.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5.43
|
| Rate for Payer: Priority Health Medicare |
$2.74
|
| Rate for Payer: Priority Health Narrow Network |
$5.43
|
| Rate for Payer: Railroad Medicare Medicare |
$2.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.74
|
| Rate for Payer: UHC Exchange |
$3.72
|
| Rate for Payer: UHCCP DNSP |
$2.74
|
|
|
PR PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS
|
Professional
|
Both
|
$5,741.00
|
|
|
Service Code
|
HCPCS 33910
|
| Min. Negotiated Rate |
$1,565.34 |
| Max. Negotiated Rate |
$4,751.24 |
| Rate for Payer: Aetna Commercial |
$3,295.21
|
| Rate for Payer: Aetna Medicare |
$2,459.11
|
| Rate for Payer: BCBS Complete |
$1,643.61
|
| Rate for Payer: BCBS MAPPO |
$2,459.11
|
| Rate for Payer: BCN Commercial |
$3,826.49
|
| Rate for Payer: BCN Medicare Advantage |
$2,459.11
|
| Rate for Payer: Cash Price |
$4,592.80
|
| Rate for Payer: Cash Price |
$4,592.80
|
| Rate for Payer: Cofinity Commercial |
$3,541.12
|
| Rate for Payer: Cofinity Commercial |
$3,295.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,459.11
|
| Rate for Payer: Healthscope Commercial |
$2,950.93
|
| Rate for Payer: Healthscope Whirlpool |
$2,950.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,582.07
|
| Rate for Payer: Meridian Medicaid |
$1,643.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,705.02
|
| Rate for Payer: Nomi Health Commercial |
$2,950.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,305.75
|
| Rate for Payer: PACE SWMI |
$2,459.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,459.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,114.91
|
| Rate for Payer: Priority Health Medicare |
$2,459.11
|
| Rate for Payer: Priority Health Narrow Network |
$4,114.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,459.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,751.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,459.11
|
| Rate for Payer: UHC Exchange |
$4,751.24
|
| Rate for Payer: UHC Medicaid |
$1,565.34
|
| Rate for Payer: UHCCP DNSP |
$2,459.11
|
| Rate for Payer: UHCCP Medicaid |
$1,565.34
|
|
|
PR PULMONARY COMPLIANCE STUDY
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 94750
|
| Min. Negotiated Rate |
$70.80 |
| Max. Negotiated Rate |
$132.75 |
| Rate for Payer: BCBS Complete |
$70.80
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.75
|
|
|
PR PULMONARY STRESS TESTING
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 94618
|
| Min. Negotiated Rate |
$35.43 |
| Max. Negotiated Rate |
$53.02 |
| Rate for Payer: Aetna Commercial |
$47.48
|
| Rate for Payer: Aetna Medicare |
$35.43
|
| Rate for Payer: BCBS MAPPO |
$35.43
|
| Rate for Payer: BCN Commercial |
$51.29
|
| Rate for Payer: BCN Medicare Advantage |
$35.43
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$47.48
|
| Rate for Payer: Cofinity Commercial |
$51.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.43
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Healthscope Whirlpool |
$42.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.97
|
| Rate for Payer: Nomi Health Commercial |
$42.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: PACE SWMI |
$35.43
|
| Rate for Payer: PHP Medicare Advantage |
$35.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$47.31
|
| Rate for Payer: Priority Health Medicare |
$35.43
|
| Rate for Payer: Priority Health Narrow Network |
$47.31
|
| Rate for Payer: Railroad Medicare Medicare |
$35.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.43
|
| Rate for Payer: UHC Exchange |
$53.02
|
| Rate for Payer: UHCCP DNSP |
$35.43
|
|
|
PR PULMONARY STRESS TESTING,SIMPLE
|
Professional
|
Both
|
$369.00
|
|
|
Service Code
|
HCPCS 94620
|
| Min. Negotiated Rate |
$147.60 |
| Max. Negotiated Rate |
$276.75 |
| Rate for Payer: BCBS Complete |
$147.60
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.75
|
|
|
PR PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 11105
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$140.25 |
| Rate for Payer: Aetna Commercial |
$28.54
|
| Rate for Payer: Aetna Medicare |
$21.30
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$29.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.30
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$30.67
|
| Rate for Payer: Cofinity Commercial |
$28.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.30
|
| Rate for Payer: Healthscope Commercial |
$25.56
|
| Rate for Payer: Healthscope Whirlpool |
$25.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.36
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.43
|
| Rate for Payer: Nomi Health Commercial |
$25.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.25
|
| Rate for Payer: PACE SWMI |
$21.30
|
| Rate for Payer: PHP Medicare Advantage |
$21.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$34.63
|
| Rate for Payer: Priority Health Medicare |
$21.30
|
| Rate for Payer: Priority Health Narrow Network |
$34.63
|
| Rate for Payer: Railroad Medicare Medicare |
$21.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.30
|
| Rate for Payer: UHC Exchange |
$46.34
|
| Rate for Payer: UHC Medicaid |
$13.63
|
| Rate for Payer: UHCCP DNSP |
$21.30
|
| Rate for Payer: UHCCP Medicaid |
$13.63
|
|
|
PR PUNCH BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 11104
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Aetna Commercial |
$50.61
|
| Rate for Payer: Aetna Medicare |
$37.77
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCBS MAPPO |
$37.77
|
| Rate for Payer: BCN Commercial |
$54.98
|
| Rate for Payer: BCN Medicare Advantage |
$37.77
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Cofinity Commercial |
$50.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.77
|
| Rate for Payer: Healthscope Commercial |
$45.32
|
| Rate for Payer: Healthscope Whirlpool |
$45.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.66
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.55
|
| Rate for Payer: Nomi Health Commercial |
$45.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.25
|
| Rate for Payer: PACE SWMI |
$37.77
|
| Rate for Payer: PHP Medicare Advantage |
$37.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$63.82
|
| Rate for Payer: Priority Health Medicare |
$37.77
|
| Rate for Payer: Priority Health Narrow Network |
$63.82
|
| Rate for Payer: Railroad Medicare Medicare |
$37.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.77
|
| Rate for Payer: UHC Exchange |
$85.35
|
| Rate for Payer: UHC Medicaid |
$24.28
|
| Rate for Payer: UHCCP DNSP |
$37.77
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 10160
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Commercial |
$118.27
|
| Rate for Payer: Aetna Medicare |
$88.26
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$88.26
|
| Rate for Payer: BCN Commercial |
$115.06
|
| Rate for Payer: BCN Medicare Advantage |
$88.26
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$127.09
|
| Rate for Payer: Cofinity Commercial |
$118.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.26
|
| Rate for Payer: Healthscope Commercial |
$105.91
|
| Rate for Payer: Healthscope Whirlpool |
$105.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.67
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.09
|
| Rate for Payer: Nomi Health Commercial |
$105.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE SWMI |
$88.26
|
| Rate for Payer: PHP Medicare Advantage |
$88.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$133.55
|
| Rate for Payer: Priority Health Medicare |
$88.26
|
| Rate for Payer: Priority Health Narrow Network |
$133.55
|
| Rate for Payer: Railroad Medicare Medicare |
$88.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$88.26
|
| Rate for Payer: UHC Exchange |
$163.18
|
| Rate for Payer: UHC Medicaid |
$58.36
|
| Rate for Payer: UHCCP DNSP |
$88.26
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
10160
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Commercial |
$118.27
|
| Rate for Payer: Aetna Medicare |
$88.26
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$88.26
|
| Rate for Payer: BCN Commercial |
$115.06
|
| Rate for Payer: BCN Medicare Advantage |
$88.26
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$127.09
|
| Rate for Payer: Cofinity Commercial |
$118.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.26
|
| Rate for Payer: Healthscope Commercial |
$105.91
|
| Rate for Payer: Healthscope Whirlpool |
$105.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.67
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.09
|
| Rate for Payer: Nomi Health Commercial |
$105.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE SWMI |
$88.26
|
| Rate for Payer: PHP Medicare Advantage |
$88.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$133.55
|
| Rate for Payer: Priority Health Medicare |
$88.26
|
| Rate for Payer: Priority Health Narrow Network |
$133.55
|
| Rate for Payer: Railroad Medicare Medicare |
$88.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$88.26
|
| Rate for Payer: UHC Exchange |
$163.18
|
| Rate for Payer: UHC Medicaid |
$58.36
|
| Rate for Payer: UHCCP DNSP |
$88.26
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Facility
|
OP
|
$221.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
10160
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$506.31 |
| Rate for Payer: Aetna Commercial |
$198.90
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$214.37
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$182.21
|
| Rate for Payer: BCN Commercial |
$182.21
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$207.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$214.37
|
| Rate for Payer: Healthscope Whirlpool |
$221.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$198.90
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.85
|
| Rate for Payer: Nomi Health Commercial |
$181.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$248.16
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$198.53
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Facility
|
IP
|
$221.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
10160
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$221.00 |
| Rate for Payer: Aetna Commercial |
$198.90
|
| Rate for Payer: ASR ASR |
$214.37
|
| Rate for Payer: BCBS Trust/PPO |
$181.49
|
| Rate for Payer: BCN Commercial |
$181.49
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$207.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.80
|
| Rate for Payer: Healthscope Commercial |
$214.37
|
| Rate for Payer: Healthscope Whirlpool |
$221.00
|
| Rate for Payer: Mclaren Commercial |
$198.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.85
|
| Rate for Payer: Nomi Health Commercial |
$181.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
|
|
PR PUNCTURE ASPIRATION CYST BREAST EACH ADDL CYST
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 19001
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: Aetna Medicare |
$18.02
|
| Rate for Payer: BCBS Complete |
$12.07
|
| Rate for Payer: BCBS MAPPO |
$18.02
|
| Rate for Payer: BCN Commercial |
$30.38
|
| Rate for Payer: BCN Medicare Advantage |
$18.02
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$25.95
|
| Rate for Payer: Cofinity Commercial |
$24.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.02
|
| Rate for Payer: Healthscope Commercial |
$21.62
|
| Rate for Payer: Healthscope Whirlpool |
$21.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.92
|
| Rate for Payer: Meridian Medicaid |
$12.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.82
|
| Rate for Payer: Nomi Health Commercial |
$21.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
| Rate for Payer: PACE SWMI |
$18.02
|
| Rate for Payer: PHP Medicare Advantage |
$18.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.80
|
| Rate for Payer: Priority Health Medicare |
$18.02
|
| Rate for Payer: Priority Health Narrow Network |
$27.80
|
| Rate for Payer: Railroad Medicare Medicare |
$18.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.02
|
| Rate for Payer: UHC Exchange |
$38.70
|
| Rate for Payer: UHC Medicaid |
$11.50
|
| Rate for Payer: UHCCP DNSP |
$18.02
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
|
|
PR PUNCTURE ASPIRATION CYST OF BREAST
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 19000
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$147.75 |
| Rate for Payer: Aetna Commercial |
$48.80
|
| Rate for Payer: Aetna Medicare |
$36.42
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS MAPPO |
$36.42
|
| Rate for Payer: BCN Commercial |
$63.24
|
| Rate for Payer: BCN Medicare Advantage |
$36.42
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$48.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$43.70
|
| Rate for Payer: Healthscope Whirlpool |
$43.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.24
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.06
|
| Rate for Payer: Nomi Health Commercial |
$43.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.75
|
| Rate for Payer: PACE SWMI |
$36.42
|
| Rate for Payer: PHP Medicare Advantage |
$36.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$57.88
|
| Rate for Payer: Priority Health Medicare |
$36.42
|
| Rate for Payer: Priority Health Narrow Network |
$57.88
|
| Rate for Payer: Railroad Medicare Medicare |
$36.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.42
|
| Rate for Payer: UHC Exchange |
$77.46
|
| Rate for Payer: UHC Medicaid |
$23.22
|
| Rate for Payer: UHCCP DNSP |
$36.42
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
|
|
PR PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX
|
Professional
|
Both
|
$413.00
|
|
|
Service Code
|
HCPCS 61070
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$309.75 |
| Rate for Payer: Aetna Commercial |
$67.76
|
| Rate for Payer: Aetna Medicare |
$50.57
|
| Rate for Payer: BCBS Complete |
$34.44
|
| Rate for Payer: BCBS MAPPO |
$50.57
|
| Rate for Payer: BCN Commercial |
$116.27
|
| Rate for Payer: BCN Medicare Advantage |
$50.57
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cofinity Commercial |
$72.82
|
| Rate for Payer: Cofinity Commercial |
$67.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.57
|
| Rate for Payer: Healthscope Commercial |
$60.68
|
| Rate for Payer: Healthscope Whirlpool |
$60.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.10
|
| Rate for Payer: Meridian Medicaid |
$34.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.63
|
| Rate for Payer: Nomi Health Commercial |
$60.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.75
|
| Rate for Payer: PACE SWMI |
$50.57
|
| Rate for Payer: PHP Medicare Advantage |
$50.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$97.76
|
| Rate for Payer: Priority Health Medicare |
$50.57
|
| Rate for Payer: Priority Health Narrow Network |
$97.76
|
| Rate for Payer: Railroad Medicare Medicare |
$50.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.57
|
| Rate for Payer: UHC Exchange |
$99.20
|
| Rate for Payer: UHC Medicaid |
$32.80
|
| Rate for Payer: UHCCP DNSP |
$50.57
|
| Rate for Payer: UHCCP Medicaid |
$32.80
|
|
|
PR PURE TONE AUDIOMETRY AIR & BONE
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 92553
|
| Min. Negotiated Rate |
$44.90 |
| Max. Negotiated Rate |
$72.21 |
| Rate for Payer: Aetna Commercial |
$60.17
|
| Rate for Payer: Aetna Medicare |
$44.90
|
| Rate for Payer: BCBS MAPPO |
$44.90
|
| Rate for Payer: BCN Commercial |
$72.21
|
| Rate for Payer: BCN Medicare Advantage |
$44.90
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$60.17
|
| Rate for Payer: Cofinity Commercial |
$64.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.90
|
| Rate for Payer: Healthscope Commercial |
$53.88
|
| Rate for Payer: Healthscope Whirlpool |
$53.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.39
|
| Rate for Payer: Nomi Health Commercial |
$53.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.25
|
| Rate for Payer: PACE SWMI |
$44.90
|
| Rate for Payer: PHP Medicare Advantage |
$44.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.59
|
| Rate for Payer: Priority Health Medicare |
$44.90
|
| Rate for Payer: Priority Health Narrow Network |
$66.59
|
| Rate for Payer: Railroad Medicare Medicare |
$44.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.90
|
| Rate for Payer: UHC Exchange |
$57.46
|
| Rate for Payer: UHCCP DNSP |
$44.90
|
|
|
PR PURE TONE AUDIOMETRY AIR ONLY
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 92552
|
| Min. Negotiated Rate |
$36.97 |
| Max. Negotiated Rate |
$59.76 |
| Rate for Payer: Aetna Commercial |
$49.54
|
| Rate for Payer: Aetna Medicare |
$36.97
|
| Rate for Payer: BCBS MAPPO |
$36.97
|
| Rate for Payer: BCN Commercial |
$59.76
|
| Rate for Payer: BCN Medicare Advantage |
$36.97
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$49.54
|
| Rate for Payer: Cofinity Commercial |
$53.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.97
|
| Rate for Payer: Healthscope Commercial |
$44.36
|
| Rate for Payer: Healthscope Whirlpool |
$44.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.67
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: PACE SWMI |
$36.97
|
| Rate for Payer: PHP Medicare Advantage |
$36.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.12
|
| Rate for Payer: Priority Health Medicare |
$36.97
|
| Rate for Payer: Priority Health Narrow Network |
$55.12
|
| Rate for Payer: Railroad Medicare Medicare |
$36.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.97
|
| Rate for Payer: UHC Exchange |
$47.37
|
| Rate for Payer: UHCCP DNSP |
$36.97
|
|
|
PR PVB THORACIC CONT CATHETER INFUSION W/IMG GID
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 64463
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$102.32
|
| Rate for Payer: Aetna Medicare |
$76.36
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$76.36
|
| Rate for Payer: BCN Commercial |
$120.51
|
| Rate for Payer: BCN Medicare Advantage |
$76.36
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$109.96
|
| Rate for Payer: Cofinity Commercial |
$102.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.36
|
| Rate for Payer: Healthscope Commercial |
$91.63
|
| Rate for Payer: Healthscope Whirlpool |
$91.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.18
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.00
|
| Rate for Payer: Nomi Health Commercial |
$91.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$76.36
|
| Rate for Payer: PHP Medicare Advantage |
$76.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$139.97
|
| Rate for Payer: Priority Health Medicare |
$76.36
|
| Rate for Payer: Priority Health Narrow Network |
$139.97
|
| Rate for Payer: Railroad Medicare Medicare |
$76.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.36
|
| Rate for Payer: UHC Exchange |
$148.27
|
| Rate for Payer: UHC Medicaid |
$48.78
|
| Rate for Payer: UHCCP DNSP |
$76.36
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
|
|
PR PYELOPLASTY COMPLICATED
|
Professional
|
Both
|
$2,748.00
|
|
|
Service Code
|
HCPCS 50405
|
| Min. Negotiated Rate |
$793.00 |
| Max. Negotiated Rate |
$2,469.79 |
| Rate for Payer: Aetna Commercial |
$1,650.83
|
| Rate for Payer: Aetna Medicare |
$1,231.96
|
| Rate for Payer: BCBS Complete |
$832.65
|
| Rate for Payer: BCBS MAPPO |
$1,231.96
|
| Rate for Payer: BCN Commercial |
$2,076.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.96
|
| Rate for Payer: Cash Price |
$2,198.40
|
| Rate for Payer: Cash Price |
$2,198.40
|
| Rate for Payer: Cofinity Commercial |
$1,774.02
|
| Rate for Payer: Cofinity Commercial |
$1,650.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.96
|
| Rate for Payer: Healthscope Commercial |
$1,478.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,478.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,293.56
|
| Rate for Payer: Meridian Medicaid |
$832.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,355.16
|
| Rate for Payer: Nomi Health Commercial |
$1,478.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,061.00
|
| Rate for Payer: PACE SWMI |
$1,231.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$793.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,261.54
|
| Rate for Payer: Priority Health Medicare |
$1,231.96
|
| Rate for Payer: Priority Health Narrow Network |
$2,261.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,469.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,231.96
|
| Rate for Payer: UHC Exchange |
$2,469.79
|
| Rate for Payer: UHC Medicaid |
$793.00
|
| Rate for Payer: UHCCP DNSP |
$1,231.96
|
| Rate for Payer: UHCCP Medicaid |
$793.00
|
|
|
PR PYELOPLASTY SIMPLE
|
Professional
|
Both
|
$1,849.00
|
|
|
Service Code
|
HCPCS 50400
|
| Min. Negotiated Rate |
$658.81 |
| Max. Negotiated Rate |
$2,058.47 |
| Rate for Payer: Aetna Commercial |
$1,370.47
|
| Rate for Payer: Aetna Medicare |
$1,022.74
|
| Rate for Payer: BCBS Complete |
$691.75
|
| Rate for Payer: BCBS MAPPO |
$1,022.74
|
| Rate for Payer: BCN Commercial |
$1,721.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,022.74
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cofinity Commercial |
$1,472.75
|
| Rate for Payer: Cofinity Commercial |
$1,370.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,022.74
|
| Rate for Payer: Healthscope Commercial |
$1,227.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,227.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,073.88
|
| Rate for Payer: Meridian Medicaid |
$691.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,125.01
|
| Rate for Payer: Nomi Health Commercial |
$1,227.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,386.75
|
| Rate for Payer: PACE SWMI |
$1,022.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,022.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,874.76
|
| Rate for Payer: Priority Health Medicare |
$1,022.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,874.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,022.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,058.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,022.74
|
| Rate for Payer: UHC Exchange |
$2,058.47
|
| Rate for Payer: UHC Medicaid |
$658.81
|
| Rate for Payer: UHCCP DNSP |
$1,022.74
|
| Rate for Payer: UHCCP Medicaid |
$658.81
|
|
|
PR PYLOROMYOTOMY CUTTING PYLORIC MUSC
|
Professional
|
Both
|
$2,324.00
|
|
|
Service Code
|
HCPCS 43520
|
| Min. Negotiated Rate |
$434.31 |
| Max. Negotiated Rate |
$1,743.00 |
| Rate for Payer: Aetna Commercial |
$904.50
|
| Rate for Payer: Aetna Medicare |
$675.00
|
| Rate for Payer: BCBS Complete |
$456.03
|
| Rate for Payer: BCBS MAPPO |
$675.00
|
| Rate for Payer: BCN Commercial |
$1,077.13
|
| Rate for Payer: BCN Medicare Advantage |
$675.00
|
| Rate for Payer: Cash Price |
$1,859.20
|
| Rate for Payer: Cash Price |
$1,859.20
|
| Rate for Payer: Cofinity Commercial |
$972.00
|
| Rate for Payer: Cofinity Commercial |
$904.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.00
|
| Rate for Payer: Healthscope Commercial |
$810.00
|
| Rate for Payer: Healthscope Whirlpool |
$810.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.75
|
| Rate for Payer: Meridian Medicaid |
$456.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$742.50
|
| Rate for Payer: Nomi Health Commercial |
$810.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,743.00
|
| Rate for Payer: PACE SWMI |
$675.00
|
| Rate for Payer: PHP Medicare Advantage |
$675.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,312.41
|
| Rate for Payer: Priority Health Medicare |
$675.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,312.41
|
| Rate for Payer: Railroad Medicare Medicare |
$675.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,218.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$675.00
|
| Rate for Payer: UHC Exchange |
$1,218.44
|
| Rate for Payer: UHC Medicaid |
$434.31
|
| Rate for Payer: UHCCP DNSP |
$675.00
|
| Rate for Payer: UHCCP Medicaid |
$434.31
|
|
