|
PR PROCTOSGMDSC RIGID CONTROL BLEEDING
|
Professional
|
Both
|
$452.00
|
|
|
Service Code
|
HCPCS 45317
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$325.46 |
| Rate for Payer: Aetna Commercial |
$146.55
|
| Rate for Payer: Aetna Medicare |
$226.00
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS Trust/PPO |
$180.68
|
| Rate for Payer: BCN Commercial |
$325.46
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.47
|
| Rate for Payer: Priority Health Narrow Network |
$197.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.96
|
| Rate for Payer: UHC Exchange |
$140.96
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
|
|
PR PROCTOSGMDSC RIGID DCMPRN VOLVULUS
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 45321
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$254.80 |
| Rate for Payer: Aetna Commercial |
$139.15
|
| Rate for Payer: Aetna Medicare |
$196.00
|
| Rate for Payer: BCBS Complete |
$70.22
|
| Rate for Payer: BCBS Trust/PPO |
$202.87
|
| Rate for Payer: BCN Commercial |
$150.03
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Meridian Medicaid |
$70.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.94
|
| Rate for Payer: Priority Health Narrow Network |
$184.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.33
|
| Rate for Payer: UHC Exchange |
$130.33
|
| Rate for Payer: UHCCP Medicaid |
$66.88
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 45308
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$302.98 |
| Rate for Payer: Aetna Commercial |
$112.47
|
| Rate for Payer: Aetna Medicare |
$155.50
|
| Rate for Payer: BCBS Complete |
$57.26
|
| Rate for Payer: BCBS Trust/PPO |
$76.60
|
| Rate for Payer: BCN Commercial |
$302.98
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Meridian Medicaid |
$57.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.53
|
| Rate for Payer: Priority Health Narrow Network |
$151.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.28
|
| Rate for Payer: UHC Exchange |
$103.28
|
| Rate for Payer: UHCCP Medicaid |
$54.53
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 45309
|
| Min. Negotiated Rate |
$57.94 |
| Max. Negotiated Rate |
$676.75 |
| Rate for Payer: Aetna Commercial |
$119.82
|
| Rate for Payer: Aetna Medicare |
$188.50
|
| Rate for Payer: BCBS Complete |
$60.84
|
| Rate for Payer: BCBS Trust/PPO |
$676.75
|
| Rate for Payer: BCN Commercial |
$311.78
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Meridian Medicaid |
$60.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.48
|
| Rate for Payer: Priority Health Narrow Network |
$160.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.70
|
| Rate for Payer: UHC Exchange |
$113.70
|
| Rate for Payer: UHCCP Medicaid |
$57.94
|
|
|
PR PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 45315
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$1,137.43 |
| Rate for Payer: Aetna Commercial |
$142.82
|
| Rate for Payer: Aetna Medicare |
$241.00
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,137.43
|
| Rate for Payer: BCN Commercial |
$336.70
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.12
|
| Rate for Payer: Priority Health Narrow Network |
$189.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.08
|
| Rate for Payer: UHC Exchange |
$133.08
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
|
|
PR PROCTOSGMDSC RIGID TNDSC STENT PLMT
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 45327
|
| Min. Negotiated Rate |
$75.62 |
| Max. Negotiated Rate |
$208.81 |
| Rate for Payer: Aetna Commercial |
$156.63
|
| Rate for Payer: Aetna Medicare |
$112.00
|
| Rate for Payer: BCBS Complete |
$79.40
|
| Rate for Payer: BCBS Trust/PPO |
$206.57
|
| Rate for Payer: BCN Commercial |
$169.57
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Meridian Medicaid |
$79.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.81
|
| Rate for Payer: Priority Health Narrow Network |
$208.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$152.89
|
| Rate for Payer: UHC Exchange |
$152.89
|
| Rate for Payer: UHCCP Medicaid |
$75.62
|
|
|
PR PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 45305
|
| Min. Negotiated Rate |
$46.86 |
| Max. Negotiated Rate |
$1,525.20 |
| Rate for Payer: Aetna Commercial |
$96.87
|
| Rate for Payer: Aetna Medicare |
$148.50
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,525.20
|
| Rate for Payer: BCN Commercial |
$267.80
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Meridian Medicaid |
$49.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.06
|
| Rate for Payer: Priority Health Narrow Network |
$130.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.48
|
| Rate for Payer: UHC Exchange |
$94.48
|
| Rate for Payer: UHCCP Medicaid |
$46.86
|
|
|
PR PROCTOSGMDSC RIGID W/DILATION
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 45303
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$1,415.70 |
| Rate for Payer: Aetna Commercial |
$112.11
|
| Rate for Payer: Aetna Medicare |
$104.00
|
| Rate for Payer: BCBS Complete |
$57.26
|
| Rate for Payer: BCBS Trust/PPO |
$520.38
|
| Rate for Payer: BCN Commercial |
$1,415.70
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Meridian Medicaid |
$57.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.74
|
| Rate for Payer: Priority Health Narrow Network |
$152.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.89
|
| Rate for Payer: UHC Exchange |
$107.89
|
| Rate for Payer: UHCCP Medicaid |
$54.53
|
|
|
PR PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$339.00
|
|
|
Service Code
|
HCPCS 45307
|
| Min. Negotiated Rate |
$64.75 |
| Max. Negotiated Rate |
$854.26 |
| Rate for Payer: Aetna Commercial |
$127.11
|
| Rate for Payer: Aetna Medicare |
$169.50
|
| Rate for Payer: BCBS Complete |
$67.99
|
| Rate for Payer: BCBS Trust/PPO |
$854.26
|
| Rate for Payer: BCN Commercial |
$316.66
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Meridian Medicaid |
$67.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.58
|
| Rate for Payer: Priority Health Narrow Network |
$179.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.26
|
| Rate for Payer: UHC Exchange |
$122.26
|
| Rate for Payer: UHCCP Medicaid |
$64.75
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 95115
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$432.68 |
| Rate for Payer: Aetna Commercial |
$9.04
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS Trust/PPO |
$432.68
|
| Rate for Payer: BCN Commercial |
$14.66
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.72
|
| Rate for Payer: Priority Health Narrow Network |
$13.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.58
|
| Rate for Payer: UHC Exchange |
$10.58
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 95117
|
| Min. Negotiated Rate |
$11.04 |
| Max. Negotiated Rate |
$446.94 |
| Rate for Payer: Aetna Commercial |
$11.04
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$446.94
|
| Rate for Payer: BCN Commercial |
$17.10
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.65
|
| Rate for Payer: Priority Health Narrow Network |
$16.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.93
|
| Rate for Payer: UHC Exchange |
$12.93
|
|
|
PR PROG DEVICE EVAL IN PERSON LEADLESS PM SYSTEM
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 0389T
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna Medicare |
$46.00
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 93280
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$707.92 |
| Rate for Payer: Aetna Commercial |
$101.66
|
| Rate for Payer: Aetna Medicare |
$110.00
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCBS Trust/PPO |
$707.92
|
| Rate for Payer: BCN Commercial |
$116.31
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.85
|
| Rate for Payer: Priority Health Narrow Network |
$50.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.45
|
| Rate for Payer: UHC Exchange |
$66.45
|
| Rate for Payer: UHCCP Medicaid |
$23.00
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 93281
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$1,457.58 |
| Rate for Payer: Aetna Commercial |
$108.43
|
| Rate for Payer: Aetna Medicare |
$115.00
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,457.58
|
| Rate for Payer: BCN Commercial |
$124.13
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.97
|
| Rate for Payer: Priority Health Narrow Network |
$56.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.07
|
| Rate for Payer: UHC Exchange |
$77.07
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR PROGRAMMED STIMJ & PACG AFTER IV DRUG INFUSION
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 93623
|
| Min. Negotiated Rate |
$34.08 |
| Max. Negotiated Rate |
$1,642.40 |
| Rate for Payer: Aetna Commercial |
$217.76
|
| Rate for Payer: Aetna Commercial |
$217.76
|
| Rate for Payer: Aetna Medicare |
$166.50
|
| Rate for Payer: Aetna Medicare |
$121.50
|
| Rate for Payer: BCBS Complete |
$35.78
|
| Rate for Payer: BCBS Complete |
$35.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.37
|
| Rate for Payer: BCN Commercial |
$1,642.40
|
| Rate for Payer: BCN Commercial |
$1,642.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Meridian Medicaid |
$35.78
|
| Rate for Payer: Meridian Medicaid |
$35.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.23
|
| Rate for Payer: Priority Health Narrow Network |
$93.23
|
| Rate for Payer: Priority Health Narrow Network |
$93.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$496.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$496.99
|
| Rate for Payer: UHC Exchange |
$496.99
|
| Rate for Payer: UHC Exchange |
$496.99
|
| Rate for Payer: UHCCP Medicaid |
$34.08
|
| Rate for Payer: UHCCP Medicaid |
$34.08
|
|
|
PR PRO HEALTH BACK SCREEN
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000022
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$189.95 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: ASR Commercial |
$49.47
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$41.76
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.95
|
| Rate for Payer: Priority Health Narrow Network |
$151.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
PR PRO HEALTH BACK SCREEN
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000022
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: ASR Commercial |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$41.56
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
PR PRO HEALTH FIT FOR DUTY EXAM
|
Facility
|
OP
|
$229.50
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51000038
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$206.55
|
| Rate for Payer: Aetna Medicare |
$114.75
|
| Rate for Payer: ASR ASR |
$222.62
|
| Rate for Payer: ASR Commercial |
$222.62
|
| Rate for Payer: BCBS Complete |
$91.80
|
| Rate for Payer: BCBS Trust/PPO |
$187.94
|
| Rate for Payer: BCN Commercial |
$177.93
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Healthscope Whirlpool |
$222.62
|
| Rate for Payer: Mclaren Commercial |
$206.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.08
|
| Rate for Payer: Nomi Health Commercial |
$188.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.09
|
| Rate for Payer: Priority Health Narrow Network |
$160.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.96
|
|
|
PR PRO HEALTH FIT FOR DUTY EXAM
|
Facility
|
IP
|
$229.50
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51000038
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$149.18 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$206.55
|
| Rate for Payer: ASR ASR |
$222.62
|
| Rate for Payer: ASR Commercial |
$222.62
|
| Rate for Payer: BCBS Trust/PPO |
$187.02
|
| Rate for Payer: BCN Commercial |
$177.93
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Healthscope Whirlpool |
$222.62
|
| Rate for Payer: Mclaren Commercial |
$206.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.08
|
| Rate for Payer: Nomi Health Commercial |
$188.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.96
|
|
|
PR PRO HEALTH LIFT TEST
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000023
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: ASR Commercial |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$41.56
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
PR PRO HEALTH LIFT TEST
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000023
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$189.95 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: ASR Commercial |
$49.47
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$41.76
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.95
|
| Rate for Payer: Priority Health Narrow Network |
$151.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
PR PRO HEALTH NURSE VISIT
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.06 |
| Max. Negotiated Rate |
$119.69 |
| Rate for Payer: Aetna Commercial |
$29.38
|
| Rate for Payer: Aetna Medicare |
$16.32
|
| Rate for Payer: ASR ASR |
$31.66
|
| Rate for Payer: ASR Commercial |
$31.66
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$25.31
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$32.64
|
| Rate for Payer: Healthscope Whirlpool |
$31.66
|
| Rate for Payer: Mclaren Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: Nomi Health Commercial |
$26.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.69
|
| Rate for Payer: Priority Health Narrow Network |
$95.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.72
|
|
|
PR PRO HEALTH NURSE VISIT
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$32.64 |
| Rate for Payer: Aetna Commercial |
$29.38
|
| Rate for Payer: ASR ASR |
$31.66
|
| Rate for Payer: ASR Commercial |
$31.66
|
| Rate for Payer: BCBS Trust/PPO |
$26.60
|
| Rate for Payer: BCN Commercial |
$25.31
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$32.64
|
| Rate for Payer: Healthscope Whirlpool |
$31.66
|
| Rate for Payer: Mclaren Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: Nomi Health Commercial |
$26.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.72
|
|
|
PR PRO HEALTH PHYSICAL AGILITY TEST
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000028
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$28.56 |
| Max. Negotiated Rate |
$211.92 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: Aetna Medicare |
$35.70
|
| Rate for Payer: ASR ASR |
$69.26
|
| Rate for Payer: ASR Commercial |
$69.26
|
| Rate for Payer: BCBS Complete |
$28.56
|
| Rate for Payer: BCBS Trust/PPO |
$58.47
|
| Rate for Payer: BCCCP Commercial |
$87.68
|
| Rate for Payer: BCN Commercial |
$55.36
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$71.40
|
| Rate for Payer: Healthscope Whirlpool |
$69.26
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.92
|
| Rate for Payer: Priority Health Narrow Network |
$169.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
|
|
PR PRO HEALTH PHYSICAL AGILITY TEST
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000028
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: ASR ASR |
$69.26
|
| Rate for Payer: ASR Commercial |
$69.26
|
| Rate for Payer: BCBS Trust/PPO |
$58.18
|
| Rate for Payer: BCN Commercial |
$55.36
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$71.40
|
| Rate for Payer: Healthscope Whirlpool |
$69.26
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
|
