|
PR PLNNING PT SPEC FENEST VISCERAL AORTIC GRAFT
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 34839
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
|
|
PR PL REJUV/PERFECT
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 00071
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Medicare |
$61.00
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
|
|
PR PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL
|
Professional
|
Both
|
$1,883.00
|
|
|
Service Code
|
HCPCS 40720
|
| Min. Negotiated Rate |
$753.20 |
| Max. Negotiated Rate |
$1,413.40 |
| Rate for Payer: Aetna Commercial |
$1,315.25
|
| Rate for Payer: Aetna Medicare |
$981.53
|
| Rate for Payer: BCBS Complete |
$753.20
|
| Rate for Payer: BCBS MAPPO |
$981.53
|
| Rate for Payer: BCN Medicare Advantage |
$981.53
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cofinity Commercial |
$1,413.40
|
| Rate for Payer: Cofinity Commercial |
$1,315.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.53
|
| Rate for Payer: Healthscope Commercial |
$1,177.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,177.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.61
|
| Rate for Payer: Nomi Health Commercial |
$1,177.84
|
| Rate for Payer: PACE SWMI |
$981.53
|
| Rate for Payer: PHP Medicare Advantage |
$981.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,223.95
|
| Rate for Payer: Priority Health Medicare |
$981.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$981.53
|
| Rate for Payer: UHC Medicare Advantage |
$981.53
|
| Rate for Payer: UHCCP DNSP |
$981.53
|
|
|
PR PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 42500
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$566.80 |
| Rate for Payer: Aetna Commercial |
$438.98
|
| Rate for Payer: Aetna Medicare |
$327.60
|
| Rate for Payer: BCBS Complete |
$348.80
|
| Rate for Payer: BCBS MAPPO |
$327.60
|
| Rate for Payer: BCN Medicare Advantage |
$327.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$471.74
|
| Rate for Payer: Cofinity Commercial |
$438.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.60
|
| Rate for Payer: Healthscope Commercial |
$393.12
|
| Rate for Payer: Healthscope Whirlpool |
$393.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.98
|
| Rate for Payer: Nomi Health Commercial |
$393.12
|
| Rate for Payer: PACE SWMI |
$327.60
|
| Rate for Payer: PHP Medicare Advantage |
$327.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: Priority Health Medicare |
$327.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.60
|
| Rate for Payer: UHC Medicare Advantage |
$327.60
|
| Rate for Payer: UHCCP DNSP |
$327.60
|
|
|
PR PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP
|
Professional
|
Both
|
$1,112.00
|
|
|
Service Code
|
HCPCS 42505
|
| Min. Negotiated Rate |
$435.25 |
| Max. Negotiated Rate |
$722.80 |
| Rate for Payer: Aetna Commercial |
$583.24
|
| Rate for Payer: Aetna Medicare |
$435.25
|
| Rate for Payer: BCBS Complete |
$444.80
|
| Rate for Payer: BCBS MAPPO |
$435.25
|
| Rate for Payer: BCN Medicare Advantage |
$435.25
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cofinity Commercial |
$626.76
|
| Rate for Payer: Cofinity Commercial |
$583.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.25
|
| Rate for Payer: Healthscope Commercial |
$522.30
|
| Rate for Payer: Healthscope Whirlpool |
$522.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$457.01
|
| Rate for Payer: Nomi Health Commercial |
$522.30
|
| Rate for Payer: PACE SWMI |
$435.25
|
| Rate for Payer: PHP Medicare Advantage |
$435.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.80
|
| Rate for Payer: Priority Health Medicare |
$435.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$435.25
|
| Rate for Payer: UHC Medicare Advantage |
$435.25
|
| Rate for Payer: UHCCP DNSP |
$435.25
|
|
|
PR PL VITALIZE
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 00070
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
|
|
PR PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY
|
Professional
|
Both
|
$3,664.00
|
|
|
Service Code
|
HCPCS 48140
|
| Min. Negotiated Rate |
$1,465.60 |
| Max. Negotiated Rate |
$2,381.60 |
| Rate for Payer: Aetna Commercial |
$2,039.06
|
| Rate for Payer: Aetna Medicare |
$1,521.69
|
| Rate for Payer: BCBS Complete |
$1,465.60
|
| Rate for Payer: BCBS MAPPO |
$1,521.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,521.69
|
| Rate for Payer: Cash Price |
$2,931.20
|
| Rate for Payer: Cash Price |
$2,931.20
|
| Rate for Payer: Cofinity Commercial |
$2,191.23
|
| Rate for Payer: Cofinity Commercial |
$2,039.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,521.69
|
| Rate for Payer: Healthscope Commercial |
$1,826.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,826.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,597.77
|
| Rate for Payer: Nomi Health Commercial |
$1,826.03
|
| Rate for Payer: PACE SWMI |
$1,521.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,521.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,381.60
|
| Rate for Payer: Priority Health Medicare |
$1,521.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,521.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,521.69
|
| Rate for Payer: UHCCP DNSP |
$1,521.69
|
|
|
PR PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY
|
Professional
|
Both
|
$5,562.00
|
|
|
Service Code
|
HCPCS 48150
|
| Min. Negotiated Rate |
$2,224.80 |
| Max. Negotiated Rate |
$4,348.93 |
| Rate for Payer: Aetna Commercial |
$4,046.92
|
| Rate for Payer: Aetna Medicare |
$3,020.09
|
| Rate for Payer: BCBS Complete |
$2,224.80
|
| Rate for Payer: BCBS MAPPO |
$3,020.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,020.09
|
| Rate for Payer: Cash Price |
$4,449.60
|
| Rate for Payer: Cash Price |
$4,449.60
|
| Rate for Payer: Cofinity Commercial |
$4,348.93
|
| Rate for Payer: Cofinity Commercial |
$4,046.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,020.09
|
| Rate for Payer: Healthscope Commercial |
$3,624.11
|
| Rate for Payer: Healthscope Whirlpool |
$3,624.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,171.09
|
| Rate for Payer: Nomi Health Commercial |
$3,624.11
|
| Rate for Payer: PACE SWMI |
$3,020.09
|
| Rate for Payer: PHP Medicare Advantage |
$3,020.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,615.30
|
| Rate for Payer: Priority Health Medicare |
$3,020.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,020.09
|
| Rate for Payer: UHC Medicare Advantage |
$3,020.09
|
| Rate for Payer: UHCCP DNSP |
$3,020.09
|
|
|
PR PNCRTECT W/PANCREATOJEJUNOSTOMY
|
Professional
|
Both
|
$8,303.00
|
|
|
Service Code
|
HCPCS 48153
|
| Min. Negotiated Rate |
$3,004.75 |
| Max. Negotiated Rate |
$5,396.95 |
| Rate for Payer: Aetna Commercial |
$4,026.36
|
| Rate for Payer: Aetna Medicare |
$3,004.75
|
| Rate for Payer: BCBS Complete |
$3,321.20
|
| Rate for Payer: BCBS MAPPO |
$3,004.75
|
| Rate for Payer: BCN Medicare Advantage |
$3,004.75
|
| Rate for Payer: Cash Price |
$6,642.40
|
| Rate for Payer: Cash Price |
$6,642.40
|
| Rate for Payer: Cofinity Commercial |
$4,326.84
|
| Rate for Payer: Cofinity Commercial |
$4,026.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,004.75
|
| Rate for Payer: Healthscope Commercial |
$3,605.70
|
| Rate for Payer: Healthscope Whirlpool |
$3,605.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,154.99
|
| Rate for Payer: Nomi Health Commercial |
$3,605.70
|
| Rate for Payer: PACE SWMI |
$3,004.75
|
| Rate for Payer: PHP Medicare Advantage |
$3,004.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,396.95
|
| Rate for Payer: Priority Health Medicare |
$3,004.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,004.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,004.75
|
| Rate for Payer: UHCCP DNSP |
$3,004.75
|
|
|
PR PNEUMOCOCCAL CONJ VACCINE 7 VALENT IM
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 90669
|
| Min. Negotiated Rate |
$46.40 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Medicare |
$58.00
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
|
|
PR PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 32940
|
| Min. Negotiated Rate |
$1,029.60 |
| Max. Negotiated Rate |
$1,707.78 |
| Rate for Payer: Aetna Commercial |
$1,589.19
|
| Rate for Payer: Aetna Medicare |
$1,185.96
|
| Rate for Payer: BCBS Complete |
$1,029.60
|
| Rate for Payer: BCBS MAPPO |
$1,185.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,185.96
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cofinity Commercial |
$1,707.78
|
| Rate for Payer: Cofinity Commercial |
$1,589.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,185.96
|
| Rate for Payer: Healthscope Commercial |
$1,423.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,423.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,245.26
|
| Rate for Payer: Nomi Health Commercial |
$1,423.15
|
| Rate for Payer: PACE SWMI |
$1,185.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,185.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,673.10
|
| Rate for Payer: Priority Health Medicare |
$1,185.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,185.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,185.96
|
| Rate for Payer: UHCCP DNSP |
$1,185.96
|
|
|
PR PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST
|
Professional
|
Both
|
$2,729.00
|
|
|
Service Code
|
HCPCS 32200
|
| Min. Negotiated Rate |
$1,091.60 |
| Max. Negotiated Rate |
$1,773.85 |
| Rate for Payer: Aetna Commercial |
$1,468.76
|
| Rate for Payer: Aetna Medicare |
$1,096.09
|
| Rate for Payer: BCBS Complete |
$1,091.60
|
| Rate for Payer: BCBS MAPPO |
$1,096.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.09
|
| Rate for Payer: Cash Price |
$2,183.20
|
| Rate for Payer: Cash Price |
$2,183.20
|
| Rate for Payer: Cofinity Commercial |
$1,578.37
|
| Rate for Payer: Cofinity Commercial |
$1,468.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,096.09
|
| Rate for Payer: Healthscope Commercial |
$1,315.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,315.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,150.89
|
| Rate for Payer: Nomi Health Commercial |
$1,315.31
|
| Rate for Payer: PACE SWMI |
$1,096.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.85
|
| Rate for Payer: Priority Health Medicare |
$1,096.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,096.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,096.09
|
| Rate for Payer: UHCCP DNSP |
$1,096.09
|
|
|
PR PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 32960
|
| Min. Negotiated Rate |
$85.92 |
| Max. Negotiated Rate |
$200.85 |
| Rate for Payer: Aetna Commercial |
$115.13
|
| Rate for Payer: Aetna Medicare |
$85.92
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: BCBS MAPPO |
$85.92
|
| Rate for Payer: BCN Medicare Advantage |
$85.92
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$123.72
|
| Rate for Payer: Cofinity Commercial |
$115.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.92
|
| Rate for Payer: Healthscope Commercial |
$103.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.22
|
| Rate for Payer: Nomi Health Commercial |
$103.10
|
| Rate for Payer: PACE SWMI |
$85.92
|
| Rate for Payer: PHP Medicare Advantage |
$85.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health Medicare |
$85.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.92
|
| Rate for Payer: UHC Medicare Advantage |
$85.92
|
| Rate for Payer: UHCCP DNSP |
$85.92
|
|
|
PR PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 55000
|
| Min. Negotiated Rate |
$80.41 |
| Max. Negotiated Rate |
$143.65 |
| Rate for Payer: Aetna Commercial |
$107.75
|
| Rate for Payer: Aetna Medicare |
$80.41
|
| Rate for Payer: BCBS Complete |
$88.40
|
| Rate for Payer: BCBS MAPPO |
$80.41
|
| Rate for Payer: BCN Medicare Advantage |
$80.41
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$115.79
|
| Rate for Payer: Cofinity Commercial |
$107.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.41
|
| Rate for Payer: Healthscope Commercial |
$96.49
|
| Rate for Payer: Healthscope Whirlpool |
$96.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.43
|
| Rate for Payer: Nomi Health Commercial |
$96.49
|
| Rate for Payer: PACE SWMI |
$80.41
|
| Rate for Payer: PHP Medicare Advantage |
$80.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health Medicare |
$80.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.41
|
| Rate for Payer: UHC Medicare Advantage |
$80.41
|
| Rate for Payer: UHCCP DNSP |
$80.41
|
|
|
PR POLIOVIRUS VACCINE INACTIVATED SUBQ/IM
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 90713
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$29.90 |
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
|
|
PR POLLICIZATION DIGIT
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
HCPCS 26550
|
| Min. Negotiated Rate |
$1,107.20 |
| Max. Negotiated Rate |
$2,256.88 |
| Rate for Payer: Aetna Commercial |
$2,100.16
|
| Rate for Payer: Aetna Medicare |
$1,567.28
|
| Rate for Payer: BCBS Complete |
$1,107.20
|
| Rate for Payer: BCBS MAPPO |
$1,567.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,567.28
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cofinity Commercial |
$2,256.88
|
| Rate for Payer: Cofinity Commercial |
$2,100.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,567.28
|
| Rate for Payer: Healthscope Commercial |
$1,880.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,880.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,645.64
|
| Rate for Payer: Nomi Health Commercial |
$1,880.74
|
| Rate for Payer: PACE SWMI |
$1,567.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,567.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.20
|
| Rate for Payer: Priority Health Medicare |
$1,567.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,567.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,567.28
|
| Rate for Payer: UHCCP DNSP |
$1,567.28
|
|
|
PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 95810
|
| Min. Negotiated Rate |
$189.60 |
| Max. Negotiated Rate |
$811.47 |
| Rate for Payer: Aetna Commercial |
$755.12
|
| Rate for Payer: Aetna Commercial |
$755.12
|
| Rate for Payer: Aetna Medicare |
$563.52
|
| Rate for Payer: Aetna Medicare |
$563.52
|
| Rate for Payer: BCBS Complete |
$398.80
|
| Rate for Payer: BCBS Complete |
$189.60
|
| Rate for Payer: BCBS MAPPO |
$563.52
|
| Rate for Payer: BCBS MAPPO |
$563.52
|
| Rate for Payer: BCN Medicare Advantage |
$563.52
|
| Rate for Payer: BCN Medicare Advantage |
$563.52
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Cofinity Commercial |
$755.12
|
| Rate for Payer: Cofinity Commercial |
$811.47
|
| Rate for Payer: Cofinity Commercial |
$755.12
|
| Rate for Payer: Cofinity Commercial |
$811.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.52
|
| Rate for Payer: Healthscope Commercial |
$676.22
|
| Rate for Payer: Healthscope Commercial |
$676.22
|
| Rate for Payer: Healthscope Whirlpool |
$676.22
|
| Rate for Payer: Healthscope Whirlpool |
$676.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.70
|
| Rate for Payer: Nomi Health Commercial |
$676.22
|
| Rate for Payer: Nomi Health Commercial |
$676.22
|
| Rate for Payer: PACE SWMI |
$563.52
|
| Rate for Payer: PACE SWMI |
$563.52
|
| Rate for Payer: PHP Medicare Advantage |
$563.52
|
| Rate for Payer: PHP Medicare Advantage |
$563.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.10
|
| Rate for Payer: Priority Health Medicare |
$563.52
|
| Rate for Payer: Priority Health Medicare |
$563.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.52
|
| Rate for Payer: UHC Medicare Advantage |
$563.52
|
| Rate for Payer: UHC Medicare Advantage |
$563.52
|
| Rate for Payer: UHCCP DNSP |
$563.52
|
| Rate for Payer: UHCCP DNSP |
$563.52
|
|
|
PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$1,736.00
|
|
|
Service Code
|
HCPCS 95782
|
| Min. Negotiated Rate |
$694.40 |
| Max. Negotiated Rate |
$1,251.98 |
| Rate for Payer: Aetna Commercial |
$1,165.04
|
| Rate for Payer: Aetna Commercial |
$1,165.04
|
| Rate for Payer: Aetna Medicare |
$869.43
|
| Rate for Payer: Aetna Medicare |
$869.43
|
| Rate for Payer: BCBS Complete |
$103.20
|
| Rate for Payer: BCBS Complete |
$694.40
|
| Rate for Payer: BCBS MAPPO |
$869.43
|
| Rate for Payer: BCBS MAPPO |
$869.43
|
| Rate for Payer: BCN Medicare Advantage |
$869.43
|
| Rate for Payer: BCN Medicare Advantage |
$869.43
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$1,165.04
|
| Rate for Payer: Cofinity Commercial |
$1,251.98
|
| Rate for Payer: Cofinity Commercial |
$1,165.04
|
| Rate for Payer: Cofinity Commercial |
$1,251.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.43
|
| Rate for Payer: Healthscope Commercial |
$1,043.32
|
| Rate for Payer: Healthscope Commercial |
$1,043.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,043.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,043.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.90
|
| Rate for Payer: Nomi Health Commercial |
$1,043.32
|
| Rate for Payer: Nomi Health Commercial |
$1,043.32
|
| Rate for Payer: PACE SWMI |
$869.43
|
| Rate for Payer: PACE SWMI |
$869.43
|
| Rate for Payer: PHP Medicare Advantage |
$869.43
|
| Rate for Payer: PHP Medicare Advantage |
$869.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,128.40
|
| Rate for Payer: Priority Health Medicare |
$869.43
|
| Rate for Payer: Priority Health Medicare |
$869.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.43
|
| Rate for Payer: UHC Medicare Advantage |
$869.43
|
| Rate for Payer: UHC Medicare Advantage |
$869.43
|
| Rate for Payer: UHCCP DNSP |
$869.43
|
| Rate for Payer: UHCCP DNSP |
$869.43
|
|
|
PR POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$1,246.00
|
|
|
Service Code
|
HCPCS 95811
|
| Min. Negotiated Rate |
$498.40 |
| Max. Negotiated Rate |
$849.89 |
| Rate for Payer: Aetna Commercial |
$790.87
|
| Rate for Payer: Aetna Commercial |
$790.87
|
| Rate for Payer: Aetna Medicare |
$590.20
|
| Rate for Payer: Aetna Medicare |
$590.20
|
| Rate for Payer: BCBS Complete |
$200.80
|
| Rate for Payer: BCBS Complete |
$498.40
|
| Rate for Payer: BCBS MAPPO |
$590.20
|
| Rate for Payer: BCBS MAPPO |
$590.20
|
| Rate for Payer: BCN Medicare Advantage |
$590.20
|
| Rate for Payer: BCN Medicare Advantage |
$590.20
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cofinity Commercial |
$790.87
|
| Rate for Payer: Cofinity Commercial |
$849.89
|
| Rate for Payer: Cofinity Commercial |
$790.87
|
| Rate for Payer: Cofinity Commercial |
$849.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.20
|
| Rate for Payer: Healthscope Commercial |
$708.24
|
| Rate for Payer: Healthscope Commercial |
$708.24
|
| Rate for Payer: Healthscope Whirlpool |
$708.24
|
| Rate for Payer: Healthscope Whirlpool |
$708.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.71
|
| Rate for Payer: Nomi Health Commercial |
$708.24
|
| Rate for Payer: Nomi Health Commercial |
$708.24
|
| Rate for Payer: PACE SWMI |
$590.20
|
| Rate for Payer: PACE SWMI |
$590.20
|
| Rate for Payer: PHP Medicare Advantage |
$590.20
|
| Rate for Payer: PHP Medicare Advantage |
$590.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.90
|
| Rate for Payer: Priority Health Medicare |
$590.20
|
| Rate for Payer: Priority Health Medicare |
$590.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.20
|
| Rate for Payer: UHC Medicare Advantage |
$590.20
|
| Rate for Payer: UHC Medicare Advantage |
$590.20
|
| Rate for Payer: UHCCP DNSP |
$590.20
|
| Rate for Payer: UHCCP DNSP |
$590.20
|
|
|
PR POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 95783
|
| Min. Negotiated Rate |
$741.20 |
| Max. Negotiated Rate |
$1,327.02 |
| Rate for Payer: Aetna Commercial |
$1,234.86
|
| Rate for Payer: Aetna Commercial |
$1,234.86
|
| Rate for Payer: Aetna Medicare |
$921.54
|
| Rate for Payer: Aetna Medicare |
$921.54
|
| Rate for Payer: BCBS Complete |
$112.80
|
| Rate for Payer: BCBS Complete |
$741.20
|
| Rate for Payer: BCBS MAPPO |
$921.54
|
| Rate for Payer: BCBS MAPPO |
$921.54
|
| Rate for Payer: BCN Medicare Advantage |
$921.54
|
| Rate for Payer: BCN Medicare Advantage |
$921.54
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$1,234.86
|
| Rate for Payer: Cofinity Commercial |
$1,327.02
|
| Rate for Payer: Cofinity Commercial |
$1,234.86
|
| Rate for Payer: Cofinity Commercial |
$1,327.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.54
|
| Rate for Payer: Healthscope Commercial |
$1,105.85
|
| Rate for Payer: Healthscope Commercial |
$1,105.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,105.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,105.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.62
|
| Rate for Payer: Nomi Health Commercial |
$1,105.85
|
| Rate for Payer: Nomi Health Commercial |
$1,105.85
|
| Rate for Payer: PACE SWMI |
$921.54
|
| Rate for Payer: PACE SWMI |
$921.54
|
| Rate for Payer: PHP Medicare Advantage |
$921.54
|
| Rate for Payer: PHP Medicare Advantage |
$921.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health Medicare |
$921.54
|
| Rate for Payer: Priority Health Medicare |
$921.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$921.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$921.54
|
| Rate for Payer: UHC Medicare Advantage |
$921.54
|
| Rate for Payer: UHC Medicare Advantage |
$921.54
|
| Rate for Payer: UHCCP DNSP |
$921.54
|
| Rate for Payer: UHCCP DNSP |
$921.54
|
|
|
PR POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND
|
Professional
|
Both
|
$1,740.00
|
|
|
Service Code
|
HCPCS 95808
|
| Min. Negotiated Rate |
$440.55 |
| Max. Negotiated Rate |
$1,131.00 |
| Rate for Payer: Aetna Commercial |
$590.34
|
| Rate for Payer: Aetna Commercial |
$590.34
|
| Rate for Payer: Aetna Medicare |
$440.55
|
| Rate for Payer: Aetna Medicare |
$440.55
|
| Rate for Payer: BCBS Complete |
$172.00
|
| Rate for Payer: BCBS Complete |
$696.00
|
| Rate for Payer: BCBS MAPPO |
$440.55
|
| Rate for Payer: BCBS MAPPO |
$440.55
|
| Rate for Payer: BCN Medicare Advantage |
$440.55
|
| Rate for Payer: BCN Medicare Advantage |
$440.55
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$1,392.00
|
| Rate for Payer: Cash Price |
$1,392.00
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$590.34
|
| Rate for Payer: Cofinity Commercial |
$634.39
|
| Rate for Payer: Cofinity Commercial |
$590.34
|
| Rate for Payer: Cofinity Commercial |
$634.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.55
|
| Rate for Payer: Healthscope Commercial |
$528.66
|
| Rate for Payer: Healthscope Commercial |
$528.66
|
| Rate for Payer: Healthscope Whirlpool |
$528.66
|
| Rate for Payer: Healthscope Whirlpool |
$528.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.58
|
| Rate for Payer: Nomi Health Commercial |
$528.66
|
| Rate for Payer: Nomi Health Commercial |
$528.66
|
| Rate for Payer: PACE SWMI |
$440.55
|
| Rate for Payer: PACE SWMI |
$440.55
|
| Rate for Payer: PHP Medicare Advantage |
$440.55
|
| Rate for Payer: PHP Medicare Advantage |
$440.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,131.00
|
| Rate for Payer: Priority Health Medicare |
$440.55
|
| Rate for Payer: Priority Health Medicare |
$440.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.55
|
| Rate for Payer: UHC Medicare Advantage |
$440.55
|
| Rate for Payer: UHC Medicare Advantage |
$440.55
|
| Rate for Payer: UHCCP DNSP |
$440.55
|
| Rate for Payer: UHCCP DNSP |
$440.55
|
|
|
PR PORTOENETEROSTOMY
|
Professional
|
Both
|
$4,815.00
|
|
|
Service Code
|
HCPCS 47701
|
| Min. Negotiated Rate |
$1,683.55 |
| Max. Negotiated Rate |
$3,129.75 |
| Rate for Payer: Aetna Commercial |
$2,255.96
|
| Rate for Payer: Aetna Medicare |
$1,683.55
|
| Rate for Payer: BCBS Complete |
$1,926.00
|
| Rate for Payer: BCBS MAPPO |
$1,683.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,683.55
|
| Rate for Payer: Cash Price |
$3,852.00
|
| Rate for Payer: Cash Price |
$3,852.00
|
| Rate for Payer: Cofinity Commercial |
$2,424.31
|
| Rate for Payer: Cofinity Commercial |
$2,255.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,683.55
|
| Rate for Payer: Healthscope Commercial |
$2,020.26
|
| Rate for Payer: Healthscope Whirlpool |
$2,020.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,767.73
|
| Rate for Payer: Nomi Health Commercial |
$2,020.26
|
| Rate for Payer: PACE SWMI |
$1,683.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,683.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,129.75
|
| Rate for Payer: Priority Health Medicare |
$1,683.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,683.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,683.55
|
| Rate for Payer: UHCCP DNSP |
$1,683.55
|
|
|
PR POSITIONAL NYSTAGMUS TEST
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 92542
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$38.72 |
| Rate for Payer: Aetna Commercial |
$36.03
|
| Rate for Payer: Aetna Medicare |
$26.89
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$26.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.89
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$38.72
|
| Rate for Payer: Cofinity Commercial |
$36.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.89
|
| Rate for Payer: Healthscope Commercial |
$32.27
|
| Rate for Payer: Healthscope Whirlpool |
$32.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.23
|
| Rate for Payer: Nomi Health Commercial |
$32.27
|
| Rate for Payer: PACE SWMI |
$26.89
|
| Rate for Payer: PHP Medicare Advantage |
$26.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health Medicare |
$26.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.89
|
| Rate for Payer: UHC Medicare Advantage |
$26.89
|
| Rate for Payer: UHCCP DNSP |
$26.89
|
|
|
PR POST-CATARACT LASER SURGERY
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 66821
|
| Min. Negotiated Rate |
$229.60 |
| Max. Negotiated Rate |
$409.32 |
| Rate for Payer: Aetna Commercial |
$380.89
|
| Rate for Payer: Aetna Medicare |
$284.25
|
| Rate for Payer: BCBS Complete |
$229.60
|
| Rate for Payer: BCBS MAPPO |
$284.25
|
| Rate for Payer: BCN Medicare Advantage |
$284.25
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$409.32
|
| Rate for Payer: Cofinity Commercial |
$380.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.25
|
| Rate for Payer: Healthscope Commercial |
$341.10
|
| Rate for Payer: Healthscope Whirlpool |
$341.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.46
|
| Rate for Payer: Nomi Health Commercial |
$341.10
|
| Rate for Payer: PACE SWMI |
$284.25
|
| Rate for Payer: PHP Medicare Advantage |
$284.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health Medicare |
$284.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$284.25
|
| Rate for Payer: UHC Medicare Advantage |
$284.25
|
| Rate for Payer: UHCCP DNSP |
$284.25
|
|
|
PR POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY
|
Professional
|
Both
|
$1,407.00
|
|
|
Service Code
|
HCPCS 57250
|
| Min. Negotiated Rate |
$562.80 |
| Max. Negotiated Rate |
$914.55 |
| Rate for Payer: Aetna Commercial |
$790.04
|
| Rate for Payer: Aetna Medicare |
$589.58
|
| Rate for Payer: BCBS Complete |
$562.80
|
| Rate for Payer: BCBS MAPPO |
$589.58
|
| Rate for Payer: BCN Medicare Advantage |
$589.58
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$849.00
|
| Rate for Payer: Cofinity Commercial |
$790.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.58
|
| Rate for Payer: Healthscope Commercial |
$707.50
|
| Rate for Payer: Healthscope Whirlpool |
$707.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.06
|
| Rate for Payer: Nomi Health Commercial |
$707.50
|
| Rate for Payer: PACE SWMI |
$589.58
|
| Rate for Payer: PHP Medicare Advantage |
$589.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health Medicare |
$589.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.58
|
| Rate for Payer: UHC Medicare Advantage |
$589.58
|
| Rate for Payer: UHCCP DNSP |
$589.58
|
|
