|
PR PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 15002
|
| Min. Negotiated Rate |
$210.50 |
| Max. Negotiated Rate |
$365.30 |
| Rate for Payer: Aetna Commercial |
$282.07
|
| Rate for Payer: Aetna Medicare |
$210.50
|
| Rate for Payer: BCBS Complete |
$224.80
|
| Rate for Payer: BCBS MAPPO |
$210.50
|
| Rate for Payer: BCN Medicare Advantage |
$210.50
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$303.12
|
| Rate for Payer: Cofinity Commercial |
$282.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.50
|
| Rate for Payer: Healthscope Commercial |
$252.60
|
| Rate for Payer: Healthscope Whirlpool |
$252.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.03
|
| Rate for Payer: Nomi Health Commercial |
$252.60
|
| Rate for Payer: PACE SWMI |
$210.50
|
| Rate for Payer: PHP Medicare Advantage |
$210.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.30
|
| Rate for Payer: Priority Health Medicare |
$210.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.50
|
| Rate for Payer: UHC Medicare Advantage |
$210.50
|
| Rate for Payer: UHCCP DNSP |
$210.50
|
|
|
PR PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 15003
|
| Min. Negotiated Rate |
$42.94 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Commercial |
$57.54
|
| Rate for Payer: Aetna Medicare |
$42.94
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$42.94
|
| Rate for Payer: BCN Medicare Advantage |
$42.94
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Cofinity Commercial |
$57.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.94
|
| Rate for Payer: Healthscope Commercial |
$51.53
|
| Rate for Payer: Healthscope Whirlpool |
$51.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.09
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: PACE SWMI |
$42.94
|
| Rate for Payer: PHP Medicare Advantage |
$42.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health Medicare |
$42.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.94
|
| Rate for Payer: UHC Medicare Advantage |
$42.94
|
| Rate for Payer: UHCCP DNSP |
$42.94
|
|
|
PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 94640
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$24.70 |
| Rate for Payer: Aetna Commercial |
$9.59
|
| Rate for Payer: Aetna Medicare |
$7.16
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$7.16
|
| Rate for Payer: BCN Medicare Advantage |
$7.16
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$9.59
|
| Rate for Payer: Cofinity Commercial |
$10.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.16
|
| Rate for Payer: Healthscope Commercial |
$8.59
|
| Rate for Payer: Healthscope Whirlpool |
$8.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.52
|
| Rate for Payer: Nomi Health Commercial |
$8.59
|
| Rate for Payer: PACE SWMI |
$7.16
|
| Rate for Payer: PHP Medicare Advantage |
$7.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Medicare |
$7.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.16
|
| Rate for Payer: UHC Medicare Advantage |
$7.16
|
| Rate for Payer: UHCCP DNSP |
$7.16
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 15 MIN
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 99401
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$42.90 |
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 30 MIN
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 99402
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$74.10 |
| Rate for Payer: Aetna Medicare |
$57.00
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 45 MIN
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 99403
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 60 MIN
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 99404
|
| Min. Negotiated Rate |
$75.20 |
| Max. Negotiated Rate |
$122.20 |
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
|
|
PR PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 99412
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
|
|
PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 93279
|
| Min. Negotiated Rate |
$60.77 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Commercial |
$81.43
|
| Rate for Payer: Aetna Medicare |
$60.77
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$60.77
|
| Rate for Payer: BCN Medicare Advantage |
$60.77
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$87.51
|
| Rate for Payer: Cofinity Commercial |
$81.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.77
|
| Rate for Payer: Healthscope Commercial |
$72.92
|
| Rate for Payer: Healthscope Whirlpool |
$72.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.81
|
| Rate for Payer: Nomi Health Commercial |
$72.92
|
| Rate for Payer: PACE SWMI |
$60.77
|
| Rate for Payer: PHP Medicare Advantage |
$60.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health Medicare |
$60.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.77
|
| Rate for Payer: UHC Medicare Advantage |
$60.77
|
| Rate for Payer: UHCCP DNSP |
$60.77
|
|
|
PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 93285
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Commercial |
$71.84
|
| Rate for Payer: Aetna Commercial |
$71.84
|
| Rate for Payer: Aetna Medicare |
$53.61
|
| Rate for Payer: Aetna Medicare |
$53.61
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$53.61
|
| Rate for Payer: BCBS MAPPO |
$53.61
|
| Rate for Payer: BCN Medicare Advantage |
$53.61
|
| Rate for Payer: BCN Medicare Advantage |
$53.61
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$71.84
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Cofinity Commercial |
$71.84
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.61
|
| Rate for Payer: Healthscope Commercial |
$64.33
|
| Rate for Payer: Healthscope Commercial |
$64.33
|
| Rate for Payer: Healthscope Whirlpool |
$64.33
|
| Rate for Payer: Healthscope Whirlpool |
$64.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.29
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: PACE SWMI |
$53.61
|
| Rate for Payer: PACE SWMI |
$53.61
|
| Rate for Payer: PHP Medicare Advantage |
$53.61
|
| Rate for Payer: PHP Medicare Advantage |
$53.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$53.61
|
| Rate for Payer: Priority Health Medicare |
$53.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.61
|
| Rate for Payer: UHC Medicare Advantage |
$53.61
|
| Rate for Payer: UHC Medicare Advantage |
$53.61
|
| Rate for Payer: UHCCP DNSP |
$53.61
|
| Rate for Payer: UHCCP DNSP |
$53.61
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 93284
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$138.18 |
| Rate for Payer: Aetna Commercial |
$128.59
|
| Rate for Payer: Aetna Medicare |
$95.96
|
| Rate for Payer: BCBS Complete |
$68.00
|
| Rate for Payer: BCBS MAPPO |
$95.96
|
| Rate for Payer: BCN Medicare Advantage |
$95.96
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Cofinity Commercial |
$128.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.96
|
| Rate for Payer: Healthscope Commercial |
$115.15
|
| Rate for Payer: Healthscope Whirlpool |
$115.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.76
|
| Rate for Payer: Nomi Health Commercial |
$115.15
|
| Rate for Payer: PACE SWMI |
$95.96
|
| Rate for Payer: PHP Medicare Advantage |
$95.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health Medicare |
$95.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.96
|
| Rate for Payer: UHC Medicare Advantage |
$95.96
|
| Rate for Payer: UHCCP DNSP |
$95.96
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 93283
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$128.02 |
| Rate for Payer: Aetna Commercial |
$119.13
|
| Rate for Payer: Aetna Medicare |
$88.90
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: BCBS MAPPO |
$88.90
|
| Rate for Payer: BCN Medicare Advantage |
$88.90
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$128.02
|
| Rate for Payer: Cofinity Commercial |
$119.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.90
|
| Rate for Payer: Healthscope Commercial |
$106.68
|
| Rate for Payer: Healthscope Whirlpool |
$106.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.34
|
| Rate for Payer: Nomi Health Commercial |
$106.68
|
| Rate for Payer: PACE SWMI |
$88.90
|
| Rate for Payer: PHP Medicare Advantage |
$88.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.70
|
| Rate for Payer: Priority Health Medicare |
$88.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.90
|
| Rate for Payer: UHC Medicare Advantage |
$88.90
|
| Rate for Payer: UHCCP DNSP |
$88.90
|
|
|
PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 93282
|
| Min. Negotiated Rate |
$49.60 |
| Max. Negotiated Rate |
$103.74 |
| Rate for Payer: Aetna Commercial |
$96.53
|
| Rate for Payer: Aetna Medicare |
$72.04
|
| Rate for Payer: BCBS Complete |
$49.60
|
| Rate for Payer: BCBS MAPPO |
$72.04
|
| Rate for Payer: BCN Medicare Advantage |
$72.04
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| Rate for Payer: Cofinity Commercial |
$103.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.04
|
| Rate for Payer: Healthscope Commercial |
$86.45
|
| Rate for Payer: Healthscope Whirlpool |
$86.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.64
|
| Rate for Payer: Nomi Health Commercial |
$86.45
|
| Rate for Payer: PACE SWMI |
$72.04
|
| Rate for Payer: PHP Medicare Advantage |
$72.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.60
|
| Rate for Payer: Priority Health Medicare |
$72.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.04
|
| Rate for Payer: UHC Medicare Advantage |
$72.04
|
| Rate for Payer: UHCCP DNSP |
$72.04
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS
|
Professional
|
Both
|
$5,726.00
|
|
|
Service Code
|
HCPCS 33031
|
| Min. Negotiated Rate |
$2,290.40 |
| Max. Negotiated Rate |
$3,721.90 |
| Rate for Payer: Aetna Commercial |
$3,177.30
|
| Rate for Payer: Aetna Medicare |
$2,371.12
|
| Rate for Payer: BCBS Complete |
$2,290.40
|
| Rate for Payer: BCBS MAPPO |
$2,371.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,371.12
|
| Rate for Payer: Cash Price |
$4,580.80
|
| Rate for Payer: Cash Price |
$4,580.80
|
| Rate for Payer: Cofinity Commercial |
$3,414.41
|
| Rate for Payer: Cofinity Commercial |
$3,177.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,371.12
|
| Rate for Payer: Healthscope Commercial |
$2,845.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,845.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,489.68
|
| Rate for Payer: Nomi Health Commercial |
$2,845.34
|
| Rate for Payer: PACE SWMI |
$2,371.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,371.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,721.90
|
| Rate for Payer: Priority Health Medicare |
$2,371.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,371.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,371.12
|
| Rate for Payer: UHCCP DNSP |
$2,371.12
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS
|
Professional
|
Both
|
$3,419.00
|
|
|
Service Code
|
HCPCS 33030
|
| Min. Negotiated Rate |
$1,367.60 |
| Max. Negotiated Rate |
$2,764.37 |
| Rate for Payer: Aetna Commercial |
$2,572.40
|
| Rate for Payer: Aetna Medicare |
$1,919.70
|
| Rate for Payer: BCBS Complete |
$1,367.60
|
| Rate for Payer: BCBS MAPPO |
$1,919.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,919.70
|
| Rate for Payer: Cash Price |
$2,735.20
|
| Rate for Payer: Cash Price |
$2,735.20
|
| Rate for Payer: Cofinity Commercial |
$2,764.37
|
| Rate for Payer: Cofinity Commercial |
$2,572.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,919.70
|
| Rate for Payer: Healthscope Commercial |
$2,303.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,303.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,015.68
|
| Rate for Payer: Nomi Health Commercial |
$2,303.64
|
| Rate for Payer: PACE SWMI |
$1,919.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,919.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,222.35
|
| Rate for Payer: Priority Health Medicare |
$1,919.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,919.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,919.70
|
| Rate for Payer: UHCCP DNSP |
$1,919.70
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST
|
Professional
|
Both
|
$4,133.00
|
|
|
Service Code
|
HCPCS 37184
|
| Min. Negotiated Rate |
$408.97 |
| Max. Negotiated Rate |
$2,686.45 |
| Rate for Payer: Aetna Commercial |
$548.02
|
| Rate for Payer: Aetna Medicare |
$408.97
|
| Rate for Payer: BCBS Complete |
$1,653.20
|
| Rate for Payer: BCBS MAPPO |
$408.97
|
| Rate for Payer: BCN Medicare Advantage |
$408.97
|
| Rate for Payer: Cash Price |
$3,306.40
|
| Rate for Payer: Cash Price |
$3,306.40
|
| Rate for Payer: Cofinity Commercial |
$588.92
|
| Rate for Payer: Cofinity Commercial |
$548.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.97
|
| Rate for Payer: Healthscope Commercial |
$490.76
|
| Rate for Payer: Healthscope Whirlpool |
$490.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$429.42
|
| Rate for Payer: Nomi Health Commercial |
$490.76
|
| Rate for Payer: PACE SWMI |
$408.97
|
| Rate for Payer: PHP Medicare Advantage |
$408.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,686.45
|
| Rate for Payer: Priority Health Medicare |
$408.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.97
|
| Rate for Payer: UHC Medicare Advantage |
$408.97
|
| Rate for Payer: UHCCP DNSP |
$408.97
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ
|
Professional
|
Both
|
$3,440.00
|
|
|
Service Code
|
HCPCS 37185
|
| Min. Negotiated Rate |
$154.79 |
| Max. Negotiated Rate |
$2,236.00 |
| Rate for Payer: Aetna Commercial |
$207.42
|
| Rate for Payer: Aetna Medicare |
$154.79
|
| Rate for Payer: BCBS Complete |
$1,376.00
|
| Rate for Payer: BCBS MAPPO |
$154.79
|
| Rate for Payer: BCN Medicare Advantage |
$154.79
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cofinity Commercial |
$222.90
|
| Rate for Payer: Cofinity Commercial |
$207.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.79
|
| Rate for Payer: Healthscope Commercial |
$185.75
|
| Rate for Payer: Healthscope Whirlpool |
$185.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.53
|
| Rate for Payer: Nomi Health Commercial |
$185.75
|
| Rate for Payer: PACE SWMI |
$154.79
|
| Rate for Payer: PHP Medicare Advantage |
$154.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,236.00
|
| Rate for Payer: Priority Health Medicare |
$154.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.79
|
| Rate for Payer: UHC Medicare Advantage |
$154.79
|
| Rate for Payer: UHCCP DNSP |
$154.79
|
|
|
PR PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 99424
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$107.90 |
| Rate for Payer: Aetna Commercial |
$95.01
|
| Rate for Payer: Aetna Medicare |
$70.90
|
| Rate for Payer: BCBS Complete |
$66.40
|
| Rate for Payer: BCBS MAPPO |
$70.90
|
| Rate for Payer: BCN Medicare Advantage |
$70.90
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$95.01
|
| Rate for Payer: Cofinity Commercial |
$102.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.90
|
| Rate for Payer: Healthscope Commercial |
$77.99
|
| Rate for Payer: Healthscope Whirlpool |
$77.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.44
|
| Rate for Payer: Nomi Health Commercial |
$85.08
|
| Rate for Payer: PACE SWMI |
$70.90
|
| Rate for Payer: PHP Medicare Advantage |
$70.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
| Rate for Payer: Priority Health Medicare |
$70.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.90
|
| Rate for Payer: UHC Medicare Advantage |
$70.90
|
| Rate for Payer: UHCCP DNSP |
$70.90
|
|
|
PR PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 99426
|
| Min. Negotiated Rate |
$46.70 |
| Max. Negotiated Rate |
$81.90 |
| Rate for Payer: Aetna Commercial |
$62.58
|
| Rate for Payer: Aetna Medicare |
$46.70
|
| Rate for Payer: BCBS Complete |
$50.40
|
| Rate for Payer: BCBS MAPPO |
$46.70
|
| Rate for Payer: BCN Medicare Advantage |
$46.70
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$67.25
|
| Rate for Payer: Cofinity Commercial |
$62.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.70
|
| Rate for Payer: Healthscope Commercial |
$51.37
|
| Rate for Payer: Healthscope Whirlpool |
$51.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.03
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: PACE SWMI |
$46.70
|
| Rate for Payer: PHP Medicare Advantage |
$46.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health Medicare |
$46.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.70
|
| Rate for Payer: UHC Medicare Advantage |
$46.70
|
| Rate for Payer: UHCCP DNSP |
$46.70
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 99427
|
| Min. Negotiated Rate |
$33.62 |
| Max. Negotiated Rate |
$63.05 |
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna Medicare |
$33.62
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCBS MAPPO |
$33.62
|
| Rate for Payer: BCN Medicare Advantage |
$33.62
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$48.41
|
| Rate for Payer: Cofinity Commercial |
$45.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.62
|
| Rate for Payer: Healthscope Commercial |
$36.98
|
| Rate for Payer: Healthscope Whirlpool |
$36.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.30
|
| Rate for Payer: Nomi Health Commercial |
$40.34
|
| Rate for Payer: PACE SWMI |
$33.62
|
| Rate for Payer: PHP Medicare Advantage |
$33.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health Medicare |
$33.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.62
|
| Rate for Payer: UHC Medicare Advantage |
$33.62
|
| Rate for Payer: UHCCP DNSP |
$33.62
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 99425
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$48.18
|
| Rate for Payer: BCBS Complete |
$48.00
|
| Rate for Payer: BCBS MAPPO |
$48.18
|
| Rate for Payer: BCN Medicare Advantage |
$48.18
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$69.38
|
| Rate for Payer: Cofinity Commercial |
$64.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.18
|
| Rate for Payer: Healthscope Commercial |
$53.00
|
| Rate for Payer: Healthscope Whirlpool |
$53.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.59
|
| Rate for Payer: Nomi Health Commercial |
$57.82
|
| Rate for Payer: PACE SWMI |
$48.18
|
| Rate for Payer: PHP Medicare Advantage |
$48.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.00
|
| Rate for Payer: Priority Health Medicare |
$48.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.18
|
| Rate for Payer: UHC Medicare Advantage |
$48.18
|
| Rate for Payer: UHCCP DNSP |
$48.18
|
|
|
PR PROBE NASOLACRIMAL DUCT W/WO IRRIGATION
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 68810
|
| Min. Negotiated Rate |
$113.60 |
| Max. Negotiated Rate |
$184.60 |
| Rate for Payer: Aetna Commercial |
$158.66
|
| Rate for Payer: Aetna Medicare |
$118.40
|
| Rate for Payer: BCBS Complete |
$113.60
|
| Rate for Payer: BCBS MAPPO |
$118.40
|
| Rate for Payer: BCN Medicare Advantage |
$118.40
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cofinity Commercial |
$170.50
|
| Rate for Payer: Cofinity Commercial |
$158.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.40
|
| Rate for Payer: Healthscope Commercial |
$142.08
|
| Rate for Payer: Healthscope Whirlpool |
$142.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.32
|
| Rate for Payer: Nomi Health Commercial |
$142.08
|
| Rate for Payer: PACE SWMI |
$118.40
|
| Rate for Payer: PHP Medicare Advantage |
$118.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.60
|
| Rate for Payer: Priority Health Medicare |
$118.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.40
|
| Rate for Payer: UHC Medicare Advantage |
$118.40
|
| Rate for Payer: UHCCP DNSP |
$118.40
|
|
|
PR PROCHLORPERAZINE INJECTION
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS J0780
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Commercial |
$2.43
|
| Rate for Payer: Aetna Medicare |
$1.81
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$1.81
|
| Rate for Payer: BCN Medicare Advantage |
$1.81
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$2.61
|
| Rate for Payer: Cofinity Commercial |
$2.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.81
|
| Rate for Payer: Healthscope Commercial |
$2.17
|
| Rate for Payer: Healthscope Whirlpool |
$2.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.90
|
| Rate for Payer: Nomi Health Commercial |
$2.17
|
| Rate for Payer: PACE SWMI |
$1.81
|
| Rate for Payer: PHP Medicare Advantage |
$1.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health Medicare |
$1.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.81
|
| Rate for Payer: UHC Medicare Advantage |
$1.81
|
| Rate for Payer: UHCCP DNSP |
$1.81
|
|
|
PR PROCTOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$3,082.00
|
|
|
Service Code
|
HCPCS 45540
|
| Min. Negotiated Rate |
$1,005.44 |
| Max. Negotiated Rate |
$2,003.30 |
| Rate for Payer: Aetna Commercial |
$1,347.29
|
| Rate for Payer: Aetna Medicare |
$1,005.44
|
| Rate for Payer: BCBS Complete |
$1,232.80
|
| Rate for Payer: BCBS MAPPO |
$1,005.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.44
|
| Rate for Payer: Cash Price |
$2,465.60
|
| Rate for Payer: Cash Price |
$2,465.60
|
| Rate for Payer: Cofinity Commercial |
$1,447.83
|
| Rate for Payer: Cofinity Commercial |
$1,347.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.44
|
| Rate for Payer: Healthscope Commercial |
$1,206.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,206.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,055.71
|
| Rate for Payer: Nomi Health Commercial |
$1,206.53
|
| Rate for Payer: PACE SWMI |
$1,005.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.30
|
| Rate for Payer: Priority Health Medicare |
$1,005.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,005.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.44
|
| Rate for Payer: UHCCP DNSP |
$1,005.44
|
|
|
PR PROCTOPEXY PERINEAL APPROACH
|
Professional
|
Both
|
$1,658.00
|
|
|
Service Code
|
HCPCS 45541
|
| Min. Negotiated Rate |
$663.20 |
| Max. Negotiated Rate |
$1,298.48 |
| Rate for Payer: Aetna Commercial |
$1,208.30
|
| Rate for Payer: Aetna Medicare |
$901.72
|
| Rate for Payer: BCBS Complete |
$663.20
|
| Rate for Payer: BCBS MAPPO |
$901.72
|
| Rate for Payer: BCN Medicare Advantage |
$901.72
|
| Rate for Payer: Cash Price |
$1,326.40
|
| Rate for Payer: Cash Price |
$1,326.40
|
| Rate for Payer: Cofinity Commercial |
$1,298.48
|
| Rate for Payer: Cofinity Commercial |
$1,208.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$901.72
|
| Rate for Payer: Healthscope Commercial |
$1,082.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,082.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$946.81
|
| Rate for Payer: Nomi Health Commercial |
$1,082.06
|
| Rate for Payer: PACE SWMI |
$901.72
|
| Rate for Payer: PHP Medicare Advantage |
$901.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,077.70
|
| Rate for Payer: Priority Health Medicare |
$901.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$901.72
|
| Rate for Payer: UHC Medicare Advantage |
$901.72
|
| Rate for Payer: UHCCP DNSP |
$901.72
|
|
