|
PR PPPS, SUBSEQ VISIT
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS G0439
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$728.00 |
| Rate for Payer: Aetna Commercial |
$129.30
|
| Rate for Payer: Aetna Medicare |
$87.50
|
| Rate for Payer: BCBS Complete |
$70.00
|
| Rate for Payer: BCBS Trust/PPO |
$728.00
|
| Rate for Payer: BCN Commercial |
$187.65
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.48
|
| Rate for Payer: Priority Health Narrow Network |
$171.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.76
|
| Rate for Payer: UHC Exchange |
$125.76
|
|
|
PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 90732
|
| Min. Negotiated Rate |
$58.40 |
| Max. Negotiated Rate |
$218.03 |
| Rate for Payer: Aetna Commercial |
$133.47
|
| Rate for Payer: Aetna Medicare |
$73.00
|
| Rate for Payer: BCBS Complete |
$58.40
|
| Rate for Payer: BCBS Trust/PPO |
$138.56
|
| Rate for Payer: BCN Commercial |
$218.03
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.50
|
| Rate for Payer: UHC Exchange |
$140.50
|
|
|
PR PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX
|
Professional
|
Both
|
$4,652.00
|
|
|
Service Code
|
HCPCS 45112
|
| Min. Negotiated Rate |
$234.04 |
| Max. Negotiated Rate |
$3,211.47 |
| Rate for Payer: Aetna Commercial |
$2,494.03
|
| Rate for Payer: Aetna Medicare |
$2,326.00
|
| Rate for Payer: BCBS Complete |
$1,208.83
|
| Rate for Payer: BCBS Trust/PPO |
$234.04
|
| Rate for Payer: BCN Commercial |
$2,621.27
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Meridian Medicaid |
$1,208.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,151.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,211.47
|
| Rate for Payer: Priority Health Narrow Network |
$3,211.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,296.04
|
| Rate for Payer: UHC Exchange |
$2,296.04
|
| Rate for Payer: UHCCP Medicaid |
$1,151.27
|
|
|
PR PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST
|
Professional
|
Both
|
$4,725.00
|
|
|
Service Code
|
HCPCS 45110
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$3,226.98 |
| Rate for Payer: Aetna Commercial |
$2,449.99
|
| Rate for Payer: Aetna Medicare |
$2,362.50
|
| Rate for Payer: BCBS Complete |
$1,211.96
|
| Rate for Payer: BCBS Trust/PPO |
$389.36
|
| Rate for Payer: BCN Commercial |
$2,639.84
|
| Rate for Payer: Cash Price |
$3,780.00
|
| Rate for Payer: Cash Price |
$3,780.00
|
| Rate for Payer: Meridian Medicaid |
$1,211.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,154.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,071.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,226.98
|
| Rate for Payer: Priority Health Narrow Network |
$3,226.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,229.10
|
| Rate for Payer: UHC Exchange |
$2,229.10
|
| Rate for Payer: UHCCP Medicaid |
$1,154.25
|
|
|
PR PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS
|
Professional
|
Both
|
$4,993.00
|
|
|
Service Code
|
HCPCS 45120
|
| Min. Negotiated Rate |
$234.57 |
| Max. Negotiated Rate |
$3,245.45 |
| Rate for Payer: Aetna Commercial |
$2,162.46
|
| Rate for Payer: Aetna Medicare |
$2,496.50
|
| Rate for Payer: BCBS Complete |
$1,079.56
|
| Rate for Payer: BCBS Trust/PPO |
$234.57
|
| Rate for Payer: BCN Commercial |
$2,334.90
|
| Rate for Payer: Cash Price |
$3,994.40
|
| Rate for Payer: Cash Price |
$3,994.40
|
| Rate for Payer: Meridian Medicaid |
$1,079.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,028.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,245.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,864.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,864.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,908.98
|
| Rate for Payer: UHC Exchange |
$1,908.98
|
| Rate for Payer: UHCCP Medicaid |
$1,028.15
|
|
|
PR PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS
|
Professional
|
Both
|
$4,900.00
|
|
|
Service Code
|
HCPCS 45121
|
| Min. Negotiated Rate |
$188.07 |
| Max. Negotiated Rate |
$3,185.00 |
| Rate for Payer: Aetna Commercial |
$2,361.59
|
| Rate for Payer: Aetna Medicare |
$2,450.00
|
| Rate for Payer: BCBS Complete |
$1,176.85
|
| Rate for Payer: BCBS Trust/PPO |
$188.07
|
| Rate for Payer: BCN Commercial |
$2,547.48
|
| Rate for Payer: Cash Price |
$3,920.00
|
| Rate for Payer: Cash Price |
$3,920.00
|
| Rate for Payer: Meridian Medicaid |
$1,176.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,120.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,185.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,125.55
|
| Rate for Payer: Priority Health Narrow Network |
$3,125.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,087.11
|
| Rate for Payer: UHC Exchange |
$2,087.11
|
| Rate for Payer: UHCCP Medicaid |
$1,120.81
|
|
|
PR PRCTECT PRTL RESCJ RECTUM TABDL APPR
|
Professional
|
Both
|
$1,973.00
|
|
|
Service Code
|
HCPCS 45111
|
| Min. Negotiated Rate |
$283.70 |
| Max. Negotiated Rate |
$1,941.92 |
| Rate for Payer: Aetna Commercial |
$1,458.02
|
| Rate for Payer: Aetna Medicare |
$986.50
|
| Rate for Payer: BCBS Complete |
$728.88
|
| Rate for Payer: BCBS Trust/PPO |
$283.70
|
| Rate for Payer: BCN Commercial |
$1,575.99
|
| Rate for Payer: Cash Price |
$1,578.40
|
| Rate for Payer: Cash Price |
$1,578.40
|
| Rate for Payer: Meridian Medicaid |
$728.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$694.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,282.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,941.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,941.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,311.11
|
| Rate for Payer: UHC Exchange |
$1,311.11
|
| Rate for Payer: UHCCP Medicaid |
$694.17
|
|
|
PR PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH
|
Professional
|
Both
|
$3,259.00
|
|
|
Service Code
|
HCPCS 45114
|
| Min. Negotiated Rate |
$86.17 |
| Max. Negotiated Rate |
$3,245.47 |
| Rate for Payer: Aetna Commercial |
$2,460.29
|
| Rate for Payer: Aetna Medicare |
$1,629.50
|
| Rate for Payer: BCBS Complete |
$1,223.14
|
| Rate for Payer: BCBS Trust/PPO |
$86.17
|
| Rate for Payer: BCN Commercial |
$2,647.17
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Meridian Medicaid |
$1,223.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,164.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,118.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,245.47
|
| Rate for Payer: Priority Health Narrow Network |
$3,245.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,183.45
|
| Rate for Payer: UHC Exchange |
$2,183.45
|
| Rate for Payer: UHCCP Medicaid |
$1,164.90
|
|
|
PR PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY
|
Professional
|
Both
|
$3,811.00
|
|
|
Service Code
|
HCPCS 45116
|
| Min. Negotiated Rate |
$187.02 |
| Max. Negotiated Rate |
$2,738.96 |
| Rate for Payer: Aetna Commercial |
$2,057.79
|
| Rate for Payer: Aetna Medicare |
$1,905.50
|
| Rate for Payer: BCBS Complete |
$1,031.03
|
| Rate for Payer: BCBS Trust/PPO |
$187.02
|
| Rate for Payer: BCN Commercial |
$2,233.26
|
| Rate for Payer: Cash Price |
$3,048.80
|
| Rate for Payer: Cash Price |
$3,048.80
|
| Rate for Payer: Meridian Medicaid |
$1,031.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$981.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,477.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,738.96
|
| Rate for Payer: Priority Health Narrow Network |
$2,738.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,894.24
|
| Rate for Payer: UHC Exchange |
$1,894.24
|
| Rate for Payer: UHCCP Medicaid |
$981.93
|
|
|
PR PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR
|
Professional
|
Both
|
$5,455.00
|
|
|
Service Code
|
HCPCS 45113
|
| Min. Negotiated Rate |
$234.57 |
| Max. Negotiated Rate |
$3,545.75 |
| Rate for Payer: Aetna Commercial |
$2,493.80
|
| Rate for Payer: Aetna Medicare |
$2,727.50
|
| Rate for Payer: BCBS Complete |
$1,241.26
|
| Rate for Payer: BCBS Trust/PPO |
$234.57
|
| Rate for Payer: BCN Commercial |
$2,697.01
|
| Rate for Payer: Cash Price |
$4,364.00
|
| Rate for Payer: Cash Price |
$4,364.00
|
| Rate for Payer: Meridian Medicaid |
$1,241.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,182.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,545.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,301.55
|
| Rate for Payer: Priority Health Narrow Network |
$3,301.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,391.96
|
| Rate for Payer: UHC Exchange |
$2,391.96
|
| Rate for Payer: UHCCP Medicaid |
$1,182.15
|
|
|
PR PRCTECT PRTL W/O ANAST PRNL APPR
|
Professional
|
Both
|
$3,047.00
|
|
|
Service Code
|
HCPCS 45123
|
| Min. Negotiated Rate |
$710.78 |
| Max. Negotiated Rate |
$2,046.11 |
| Rate for Payer: Aetna Commercial |
$1,489.82
|
| Rate for Payer: Aetna Medicare |
$1,523.50
|
| Rate for Payer: BCBS Complete |
$746.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,046.11
|
| Rate for Payer: BCN Commercial |
$1,621.92
|
| Rate for Payer: Cash Price |
$2,437.60
|
| Rate for Payer: Cash Price |
$2,437.60
|
| Rate for Payer: Meridian Medicaid |
$746.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$710.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,980.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,981.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,981.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,336.31
|
| Rate for Payer: UHC Exchange |
$1,336.31
|
| Rate for Payer: UHCCP Medicaid |
$710.78
|
|
|
PR PREDNISONE IR OR DR ORAL 1MG
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J7512
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.65 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.50
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.01
|
|
|
PR PREDNISONE ORAL
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J7506
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$0.65 |
| Rate for Payer: Aetna Medicare |
$0.50
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.65
|
|
|
PR PREPARE FECAL MICROBIOTA FOR INSTILLATION
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 44705
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$252.00 |
| Rate for Payer: Aetna Commercial |
$96.49
|
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS Trust/PPO |
$252.00
|
| Rate for Payer: BCN Commercial |
$163.71
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.48
|
| Rate for Payer: Priority Health Narrow Network |
$126.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.83
|
| Rate for Payer: UHC Exchange |
$99.83
|
| Rate for Payer: UHCCP Medicaid |
$45.58
|
|
|
PR PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 49013
|
| Min. Negotiated Rate |
$290.11 |
| Max. Negotiated Rate |
$808.98 |
| Rate for Payer: Aetna Commercial |
$585.87
|
| Rate for Payer: Aetna Medicare |
$471.00
|
| Rate for Payer: BCBS Complete |
$304.62
|
| Rate for Payer: BCBS Trust/PPO |
$562.11
|
| Rate for Payer: BCN Commercial |
$660.20
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Meridian Medicaid |
$304.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$808.98
|
| Rate for Payer: Priority Health Narrow Network |
$808.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$586.16
|
| Rate for Payer: UHC Exchange |
$586.16
|
| Rate for Payer: UHCCP Medicaid |
$290.11
|
|
|
PR PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 15004
|
| Min. Negotiated Rate |
$138.90 |
| Max. Negotiated Rate |
$576.64 |
| Rate for Payer: Aetna Commercial |
$285.16
|
| Rate for Payer: Aetna Medicare |
$335.00
|
| Rate for Payer: BCBS Complete |
$174.67
|
| Rate for Payer: BCBS Trust/PPO |
$138.90
|
| Rate for Payer: BCN Commercial |
$576.64
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Meridian Medicaid |
$174.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.12
|
| Rate for Payer: Priority Health Narrow Network |
$348.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.47
|
| Rate for Payer: UHC Exchange |
$295.47
|
| Rate for Payer: UHCCP Medicaid |
$166.35
|
|
|
PR PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 15005
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$206.12 |
| Rate for Payer: Aetna Commercial |
$99.66
|
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: BCBS Complete |
$59.93
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$169.57
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Meridian Medicaid |
$59.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.10
|
| Rate for Payer: Priority Health Narrow Network |
$120.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.41
|
| Rate for Payer: UHC Exchange |
$98.41
|
| Rate for Payer: UHCCP Medicaid |
$57.08
|
|
|
PR PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 15002
|
| Min. Negotiated Rate |
$138.90 |
| Max. Negotiated Rate |
$505.78 |
| Rate for Payer: Aetna Commercial |
$240.02
|
| Rate for Payer: Aetna Medicare |
$281.00
|
| Rate for Payer: BCBS Complete |
$147.61
|
| Rate for Payer: BCBS Trust/PPO |
$138.90
|
| Rate for Payer: BCN Commercial |
$505.78
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Meridian Medicaid |
$147.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.84
|
| Rate for Payer: Priority Health Narrow Network |
$294.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$241.70
|
| Rate for Payer: UHC Exchange |
$241.70
|
| Rate for Payer: UHCCP Medicaid |
$140.58
|
|
|
PR PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 15003
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$138.90 |
| Rate for Payer: Aetna Commercial |
$49.66
|
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS Trust/PPO |
$138.90
|
| Rate for Payer: BCN Commercial |
$101.65
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.51
|
| Rate for Payer: Priority Health Narrow Network |
$60.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.82
|
| Rate for Payer: UHC Exchange |
$49.82
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
|
|
PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 94640
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$255.17 |
| Rate for Payer: Aetna Commercial |
$14.62
|
| Rate for Payer: Aetna Medicare |
$19.00
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Trust/PPO |
$255.17
|
| Rate for Payer: BCN Commercial |
$13.19
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.86
|
| Rate for Payer: Priority Health Narrow Network |
$10.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.20
|
| Rate for Payer: UHC Exchange |
$14.20
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 15 MIN
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 99401
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$1,234.11 |
| Rate for Payer: Aetna Commercial |
$25.12
|
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,234.11
|
| Rate for Payer: BCN Commercial |
$56.19
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.41
|
| Rate for Payer: Priority Health Narrow Network |
$31.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.98
|
| Rate for Payer: UHC Exchange |
$26.98
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 30 MIN
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 99402
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$1,381.50 |
| Rate for Payer: Aetna Commercial |
$51.32
|
| Rate for Payer: Aetna Medicare |
$57.00
|
| Rate for Payer: BCBS Complete |
$31.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,381.50
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Meridian Medicaid |
$31.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.72
|
| Rate for Payer: Priority Health Narrow Network |
$63.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.61
|
| Rate for Payer: UHC Exchange |
$55.61
|
| Rate for Payer: UHCCP Medicaid |
$30.03
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 45 MIN
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 99403
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$393.06 |
| Rate for Payer: Aetna Commercial |
$76.44
|
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS Trust/PPO |
$393.06
|
| Rate for Payer: BCN Commercial |
$125.10
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.13
|
| Rate for Payer: Priority Health Narrow Network |
$95.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.59
|
| Rate for Payer: UHC Exchange |
$82.59
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 60 MIN
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 99404
|
| Min. Negotiated Rate |
$60.71 |
| Max. Negotiated Rate |
$805.13 |
| Rate for Payer: Aetna Commercial |
$101.22
|
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: BCBS Complete |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$805.13
|
| Rate for Payer: BCN Commercial |
$159.31
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Meridian Medicaid |
$63.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.98
|
| Rate for Payer: Priority Health Narrow Network |
$126.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.36
|
| Rate for Payer: UHC Exchange |
$110.36
|
| Rate for Payer: UHCCP Medicaid |
$60.71
|
|
|
PR PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 99412
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$1,314.41 |
| Rate for Payer: Aetna Commercial |
$13.09
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.41
|
| Rate for Payer: BCN Commercial |
$36.65
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.61
|
| Rate for Payer: Priority Health Narrow Network |
$16.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.09
|
| Rate for Payer: UHC Exchange |
$14.09
|
|
