|
PR PSYCHOANALYSIS
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 90845
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$353.96 |
| Rate for Payer: Aetna Commercial |
$96.55
|
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS Trust/PPO |
$353.96
|
| Rate for Payer: BCN Commercial |
$99.96
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.24
|
| Rate for Payer: Priority Health Narrow Network |
$103.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.55
|
| Rate for Payer: UHC Exchange |
$85.55
|
|
|
PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 96131
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$1,854.86 |
| Rate for Payer: Aetna Commercial |
$90.37
|
| Rate for Payer: Aetna Medicare |
$91.00
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,854.86
|
| Rate for Payer: BCN Commercial |
$125.10
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.77
|
| Rate for Payer: Priority Health Narrow Network |
$101.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.11
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
|
|
PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 96130
|
| Min. Negotiated Rate |
$69.86 |
| Max. Negotiated Rate |
$1,286.94 |
| Rate for Payer: Aetna Commercial |
$119.92
|
| Rate for Payer: Aetna Medicare |
$119.50
|
| Rate for Payer: BCBS Complete |
$73.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,286.94
|
| Rate for Payer: BCN Commercial |
$173.48
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Meridian Medicaid |
$73.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.00
|
| Rate for Payer: Priority Health Narrow Network |
$147.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.70
|
| Rate for Payer: UHC Exchange |
$119.70
|
| Rate for Payer: UHCCP Medicaid |
$69.86
|
|
|
PR PSYCHOLOGIC TESTING ADMIN BY COMPUTER
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 96103
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$35.75 |
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
|
|
PR PSYCHOLOGIC TESTING BY PSYCH/PHYS
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 96101
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$96.85 |
| Rate for Payer: Aetna Medicare |
$74.50
|
| Rate for Payer: BCBS Complete |
$59.60
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.85
|
|
|
PR PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 90785
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$294.26 |
| Rate for Payer: Aetna Commercial |
$15.85
|
| Rate for Payer: Aetna Medicare |
$72.00
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS Trust/PPO |
$294.26
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.51
|
| Rate for Payer: Priority Health Narrow Network |
$6.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.42
|
| Rate for Payer: UHC Exchange |
$5.42
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
|
|
PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 90840
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$660.38 |
| Rate for Payer: Aetna Commercial |
$74.88
|
| Rate for Payer: Aetna Medicare |
$59.00
|
| Rate for Payer: BCBS Complete |
$44.73
|
| Rate for Payer: BCBS Trust/PPO |
$660.38
|
| Rate for Payer: BCN Commercial |
$81.28
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Meridian Medicaid |
$44.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.28
|
| Rate for Payer: Priority Health Narrow Network |
$56.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.31
|
| Rate for Payer: UHC Exchange |
$96.31
|
| Rate for Payer: UHCCP Medicaid |
$42.60
|
|
|
PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 90839
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$311.17 |
| Rate for Payer: Aetna Commercial |
$150.80
|
| Rate for Payer: Aetna Medicare |
$115.00
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$163.74
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.13
|
| Rate for Payer: Priority Health Narrow Network |
$158.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.97
|
| Rate for Payer: UHC Exchange |
$185.97
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
|
|
PR PSYCHOTHERAPY W/PATIENT 30 MINUTES
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 90832
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$1,348.22 |
| Rate for Payer: Aetna Commercial |
$72.80
|
| Rate for Payer: Aetna Medicare |
$55.50
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,348.22
|
| Rate for Payer: BCN Commercial |
$87.56
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.97
|
| Rate for Payer: Priority Health Narrow Network |
$66.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.70
|
| Rate for Payer: UHC Exchange |
$55.70
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
|
PR PSYCHOTHERAPY W/PATIENT 45 MINUTES
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 90834
|
| Min. Negotiated Rate |
$59.85 |
| Max. Negotiated Rate |
$300.07 |
| Rate for Payer: Aetna Commercial |
$114.40
|
| Rate for Payer: Aetna Medicare |
$85.00
|
| Rate for Payer: BCBS Complete |
$62.84
|
| Rate for Payer: BCBS Trust/PPO |
$300.07
|
| Rate for Payer: BCN Commercial |
$115.84
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Meridian Medicaid |
$62.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.96
|
| Rate for Payer: Priority Health Narrow Network |
$103.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.56
|
| Rate for Payer: UHC Exchange |
$83.56
|
| Rate for Payer: UHCCP Medicaid |
$59.85
|
|
|
PR PSYCHOTHERAPY W/PATIENT 60 MINUTES
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 90837
|
| Min. Negotiated Rate |
$88.61 |
| Max. Negotiated Rate |
$286.87 |
| Rate for Payer: Aetna Commercial |
$168.48
|
| Rate for Payer: Aetna Medicare |
$119.00
|
| Rate for Payer: BCBS Complete |
$93.04
|
| Rate for Payer: BCBS Trust/PPO |
$286.87
|
| Rate for Payer: BCN Commercial |
$170.41
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Meridian Medicaid |
$93.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.60
|
| Rate for Payer: Priority Health Narrow Network |
$151.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.09
|
| Rate for Payer: UHC Exchange |
$126.09
|
| Rate for Payer: UHCCP Medicaid |
$88.61
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 90833
|
| Min. Negotiated Rate |
$36.72 |
| Max. Negotiated Rate |
$300.07 |
| Rate for Payer: Aetna Commercial |
$78.00
|
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS Trust/PPO |
$300.07
|
| Rate for Payer: BCN Commercial |
$36.72
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.27
|
| Rate for Payer: Priority Health Narrow Network |
$56.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Exchange |
$46.69
|
| Rate for Payer: UHCCP Medicaid |
$42.39
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 90836
|
| Min. Negotiated Rate |
$46.57 |
| Max. Negotiated Rate |
$318.04 |
| Rate for Payer: Aetna Commercial |
$126.88
|
| Rate for Payer: Aetna Medicare |
$86.00
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$46.57
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.08
|
| Rate for Payer: Priority Health Narrow Network |
$92.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.38
|
| Rate for Payer: UHC Exchange |
$76.38
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 90838
|
| Min. Negotiated Rate |
$61.62 |
| Max. Negotiated Rate |
$183.04 |
| Rate for Payer: Aetna Commercial |
$183.04
|
| Rate for Payer: Aetna Medicare |
$118.50
|
| Rate for Payer: BCBS Complete |
$75.59
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: BCN Commercial |
$61.62
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Meridian Medicaid |
$75.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.89
|
| Rate for Payer: Priority Health Narrow Network |
$147.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.67
|
| Rate for Payer: UHC Exchange |
$122.67
|
| Rate for Payer: UHCCP Medicaid |
$71.99
|
|
|
PR PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 96146
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$303.77 |
| Rate for Payer: Aetna Commercial |
$2.16
|
| Rate for Payer: Aetna Medicare |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS Trust/PPO |
$303.77
|
| Rate for Payer: BCN Commercial |
$3.42
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.17
|
| Rate for Payer: Priority Health Narrow Network |
$3.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.28
|
| Rate for Payer: UHC Exchange |
$2.28
|
|
|
PR PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
HCPCS 96137
|
| Min. Negotiated Rate |
$11.29 |
| Max. Negotiated Rate |
$308.53 |
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Medicare |
$43.00
|
| Rate for Payer: BCBS Complete |
$11.85
|
| Rate for Payer: BCBS Trust/PPO |
$308.53
|
| Rate for Payer: BCN Commercial |
$56.68
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Meridian Medicaid |
$11.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.97
|
| Rate for Payer: Priority Health Narrow Network |
$23.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.25
|
| Rate for Payer: UHC Exchange |
$21.25
|
| Rate for Payer: UHCCP Medicaid |
$11.29
|
|
|
PR PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 96138
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$313.81 |
| Rate for Payer: Aetna Commercial |
$38.12
|
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS Trust/PPO |
$313.81
|
| Rate for Payer: BCN Commercial |
$49.36
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.59
|
| Rate for Payer: Priority Health Narrow Network |
$46.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.27
|
| Rate for Payer: UHC Exchange |
$40.27
|
|
|
PR PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 96139
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$342.87 |
| Rate for Payer: Aetna Commercial |
$38.12
|
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS Trust/PPO |
$342.87
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.94
|
| Rate for Payer: Priority Health Narrow Network |
$47.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.27
|
| Rate for Payer: UHC Exchange |
$40.27
|
|
|
PR PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 96136
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$227.17 |
| Rate for Payer: Aetna Commercial |
$26.94
|
| Rate for Payer: Aetna Medicare |
$47.00
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS Trust/PPO |
$227.17
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.21
|
| Rate for Payer: Priority Health Narrow Network |
$31.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.02
|
| Rate for Payer: UHC Exchange |
$27.02
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
|
PR PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH
|
Professional
|
Both
|
$2,219.00
|
|
|
Service Code
|
HCPCS 31040
|
| Min. Negotiated Rate |
$514.61 |
| Max. Negotiated Rate |
$1,442.35 |
| Rate for Payer: Aetna Commercial |
$1,025.23
|
| Rate for Payer: Aetna Medicare |
$1,109.50
|
| Rate for Payer: BCBS Complete |
$540.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.47
|
| Rate for Payer: BCN Commercial |
$1,190.91
|
| Rate for Payer: Cash Price |
$1,775.20
|
| Rate for Payer: Cash Price |
$1,775.20
|
| Rate for Payer: Meridian Medicaid |
$540.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,128.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,128.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$820.51
|
| Rate for Payer: UHC Exchange |
$820.51
|
| Rate for Payer: UHCCP Medicaid |
$514.61
|
|
|
PR PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 96160
|
| Min. Negotiated Rate |
$2.85 |
| Max. Negotiated Rate |
$124.15 |
| Rate for Payer: Aetna Commercial |
$2.85
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$124.15
|
| Rate for Payer: BCN Commercial |
$3.91
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.43
|
| Rate for Payer: Priority Health Narrow Network |
$5.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.84
|
| Rate for Payer: UHC Exchange |
$4.84
|
|
|
PR PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS
|
Professional
|
Both
|
$5,574.00
|
|
|
Service Code
|
HCPCS 33910
|
| Min. Negotiated Rate |
$727.47 |
| Max. Negotiated Rate |
$4,070.05 |
| Rate for Payer: Aetna Commercial |
$3,520.01
|
| Rate for Payer: Aetna Medicare |
$2,787.00
|
| Rate for Payer: BCBS Complete |
$1,718.52
|
| Rate for Payer: BCBS Trust/PPO |
$727.47
|
| Rate for Payer: BCN Commercial |
$3,777.48
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Meridian Medicaid |
$1,718.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,636.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,070.05
|
| Rate for Payer: Priority Health Narrow Network |
$4,070.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,194.33
|
| Rate for Payer: UHC Exchange |
$2,194.33
|
| Rate for Payer: UHCCP Medicaid |
$1,636.69
|
|
|
PR PULMONARY COMPLIANCE STUDY
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 94750
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Aetna Medicare |
$86.00
|
| Rate for Payer: BCBS Complete |
$68.80
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
|
|
PR PULMONARY STRESS TESTING
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 94618
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$442.72 |
| Rate for Payer: Aetna Commercial |
$36.28
|
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: BCBS Complete |
$14.54
|
| Rate for Payer: BCBS Trust/PPO |
$442.72
|
| Rate for Payer: BCN Commercial |
$48.87
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Meridian Medicaid |
$14.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.40
|
| Rate for Payer: Priority Health Narrow Network |
$29.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.97
|
| Rate for Payer: UHC Exchange |
$36.97
|
| Rate for Payer: UHCCP Medicaid |
$13.85
|
|
|
PR PULMONARY STRESS TESTING,SIMPLE
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 94620
|
| Min. Negotiated Rate |
$143.20 |
| Max. Negotiated Rate |
$232.70 |
| Rate for Payer: Aetna Medicare |
$179.00
|
| Rate for Payer: BCBS Complete |
$143.20
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
|
