|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Professional
|
Both
|
$3,986.00
|
|
|
Service Code
|
HCPCS 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$2,590.90 |
| Rate for Payer: Aetna Commercial |
$1,298.68
|
| Rate for Payer: Aetna Medicare |
$1,993.00
|
| Rate for Payer: BCBS Complete |
$666.70
|
| Rate for Payer: BCBS Trust/PPO |
$120.13
|
| Rate for Payer: BCN Commercial |
$1,576.02
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Meridian Medicaid |
$666.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,590.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,502.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,502.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.08
|
| Rate for Payer: UHC Exchange |
$1,116.08
|
| Rate for Payer: UHCCP Medicaid |
$634.95
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Facility
|
OP
|
$3,986.00
|
|
|
Service Code
|
CPT 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$2,590.90 |
| Max. Negotiated Rate |
$10,848.88 |
| Rate for Payer: Aetna Commercial |
$3,587.40
|
| Rate for Payer: Aetna Medicare |
$6,999.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: ASR ASR |
$3,866.42
|
| Rate for Payer: ASR Commercial |
$3,866.42
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,264.14
|
| Rate for Payer: BCN Commercial |
$3,090.35
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cofinity Commercial |
$3,746.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,188.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$3,986.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,866.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,999.28
|
| Rate for Payer: Mclaren Commercial |
$3,587.40
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,388.10
|
| Rate for Payer: Nomi Health Commercial |
$3,268.52
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$7,699.21
|
| Rate for Payer: PHP Medicaid |
$3,751.61
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,590.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,492.53
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,794.19
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,507.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$10,848.88
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP DNSP |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
PR RECONSTRUCTION TOE POLYDACTYLY
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 28344
|
| Min. Negotiated Rate |
$181.69 |
| Max. Negotiated Rate |
$2,741.35 |
| Rate for Payer: Aetna Commercial |
$367.99
|
| Rate for Payer: Aetna Medicare |
$412.50
|
| Rate for Payer: BCBS Complete |
$190.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,741.35
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Meridian Medicaid |
$190.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.49
|
| Rate for Payer: Priority Health Narrow Network |
$430.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$351.40
|
| Rate for Payer: UHC Exchange |
$351.40
|
| Rate for Payer: UHCCP Medicaid |
$181.69
|
|
|
PR RECONSTRUCTION VENA CAVA ANY METHOD
|
Professional
|
Both
|
$2,399.00
|
|
|
Service Code
|
HCPCS 34502
|
| Min. Negotiated Rate |
$972.77 |
| Max. Negotiated Rate |
$2,424.05 |
| Rate for Payer: Aetna Commercial |
$2,077.33
|
| Rate for Payer: Aetna Medicare |
$1,199.50
|
| Rate for Payer: BCBS Complete |
$1,021.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,399.01
|
| Rate for Payer: BCN Commercial |
$2,200.03
|
| Rate for Payer: Cash Price |
$1,919.20
|
| Rate for Payer: Cash Price |
$1,919.20
|
| Rate for Payer: Meridian Medicaid |
$1,021.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$972.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,559.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,424.05
|
| Rate for Payer: Priority Health Narrow Network |
$2,424.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,019.83
|
| Rate for Payer: UHC Exchange |
$2,019.83
|
| Rate for Payer: UHCCP Medicaid |
$972.77
|
|
|
PR RECTAL SESATION TONE & COMPLIANCE TEST
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 91120
|
| Min. Negotiated Rate |
$30.25 |
| Max. Negotiated Rate |
$1,003.77 |
| Rate for Payer: Aetna Commercial |
$562.84
|
| Rate for Payer: Aetna Commercial |
$562.84
|
| Rate for Payer: Aetna Medicare |
$46.00
|
| Rate for Payer: Aetna Medicare |
$355.00
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.77
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$461.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.23
|
| Rate for Payer: Priority Health Narrow Network |
$64.23
|
| Rate for Payer: Priority Health Narrow Network |
$64.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$388.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$388.36
|
| Rate for Payer: UHC Exchange |
$388.36
|
| Rate for Payer: UHC Exchange |
$388.36
|
| Rate for Payer: UHCCP Medicaid |
$30.25
|
| Rate for Payer: UHCCP Medicaid |
$30.25
|
|
|
PR RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC
|
Professional
|
Both
|
$1,793.00
|
|
|
Service Code
|
HCPCS 0184T
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$4,847.67 |
| Rate for Payer: Aetna Commercial |
$771.30
|
| Rate for Payer: Aetna Medicare |
$896.50
|
| Rate for Payer: BCBS Complete |
$717.20
|
| Rate for Payer: BCBS Trust/PPO |
$25.64
|
| Rate for Payer: BCN Commercial |
$4,847.67
|
| Rate for Payer: Cash Price |
$1,434.40
|
| Rate for Payer: Cash Price |
$1,434.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,165.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,238.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,238.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$934.13
|
| Rate for Payer: UHC Exchange |
$934.13
|
|
|
PR REGION IV LOCAL ANESTH,UPPER/LOWER EXT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01995
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
|
|
PR REIMPLANTATION ANOMALOUS PULMONARY ARTERY
|
Professional
|
Both
|
$6,703.00
|
|
|
Service Code
|
HCPCS 33788
|
| Min. Negotiated Rate |
$965.96 |
| Max. Negotiated Rate |
$4,356.95 |
| Rate for Payer: Aetna Commercial |
$2,061.08
|
| Rate for Payer: Aetna Medicare |
$3,351.50
|
| Rate for Payer: BCBS Complete |
$1,014.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,462.33
|
| Rate for Payer: BCN Commercial |
$2,201.00
|
| Rate for Payer: Cash Price |
$5,362.40
|
| Rate for Payer: Cash Price |
$5,362.40
|
| Rate for Payer: Meridian Medicaid |
$1,014.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$965.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,356.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,404.91
|
| Rate for Payer: Priority Health Narrow Network |
$2,404.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,858.35
|
| Rate for Payer: UHC Exchange |
$1,858.35
|
| Rate for Payer: UHCCP Medicaid |
$965.96
|
|
|
PR REINSERTION SPINAL FIXATION DEVICE
|
Professional
|
Both
|
$5,000.00
|
|
|
Service Code
|
HCPCS 22849
|
| Min. Negotiated Rate |
$136.69 |
| Max. Negotiated Rate |
$3,250.00 |
| Rate for Payer: Aetna Commercial |
$1,754.05
|
| Rate for Payer: Aetna Medicare |
$2,500.00
|
| Rate for Payer: BCBS Complete |
$889.68
|
| Rate for Payer: BCBS Trust/PPO |
$136.69
|
| Rate for Payer: BCN Commercial |
$2,110.86
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Meridian Medicaid |
$889.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$847.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,250.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,011.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,011.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,517.17
|
| Rate for Payer: UHC Exchange |
$1,517.17
|
| Rate for Payer: UHCCP Medicaid |
$847.31
|
|
|
PR RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE
|
Professional
|
Both
|
$1,043.00
|
|
|
Service Code
|
HCPCS 26593
|
| Min. Negotiated Rate |
$390.41 |
| Max. Negotiated Rate |
$998.89 |
| Rate for Payer: Aetna Commercial |
$849.31
|
| Rate for Payer: Aetna Medicare |
$521.50
|
| Rate for Payer: BCBS Complete |
$437.24
|
| Rate for Payer: BCBS Trust/PPO |
$390.41
|
| Rate for Payer: BCN Commercial |
$960.74
|
| Rate for Payer: Cash Price |
$834.40
|
| Rate for Payer: Cash Price |
$834.40
|
| Rate for Payer: Meridian Medicaid |
$437.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$998.89
|
| Rate for Payer: Priority Health Narrow Network |
$998.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$654.36
|
| Rate for Payer: UHC Exchange |
$654.36
|
| Rate for Payer: UHCCP Medicaid |
$416.42
|
|
|
PR RELEASE/RECESSION HAMSTRING PROXIMAL
|
Professional
|
Both
|
$2,326.00
|
|
|
Service Code
|
HCPCS 27097
|
| Min. Negotiated Rate |
$447.30 |
| Max. Negotiated Rate |
$1,511.90 |
| Rate for Payer: Aetna Commercial |
$911.61
|
| Rate for Payer: Aetna Medicare |
$1,163.00
|
| Rate for Payer: BCBS Complete |
$469.66
|
| Rate for Payer: BCBS Trust/PPO |
$828.90
|
| Rate for Payer: BCN Commercial |
$1,008.63
|
| Rate for Payer: Cash Price |
$1,860.80
|
| Rate for Payer: Cash Price |
$1,860.80
|
| Rate for Payer: Meridian Medicaid |
$469.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,058.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,058.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$764.26
|
| Rate for Payer: UHC Exchange |
$764.26
|
| Rate for Payer: UHCCP Medicaid |
$447.30
|
|
|
PR RELEASE TARSAL TUNNEL
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 28035
|
| Min. Negotiated Rate |
$184.38 |
| Max. Negotiated Rate |
$899.60 |
| Rate for Payer: Aetna Commercial |
$471.96
|
| Rate for Payer: Aetna Medicare |
$692.00
|
| Rate for Payer: BCBS Complete |
$247.80
|
| Rate for Payer: BCBS Trust/PPO |
$184.38
|
| Rate for Payer: BCN Commercial |
$771.63
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Meridian Medicaid |
$247.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.14
|
| Rate for Payer: Priority Health Narrow Network |
$553.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$417.86
|
| Rate for Payer: UHC Exchange |
$417.86
|
| Rate for Payer: UHCCP Medicaid |
$236.00
|
|
|
PR RELEASE THENAR MUSCLE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26508
|
| Min. Negotiated Rate |
$435.80 |
| Max. Negotiated Rate |
$3,420.21 |
| Rate for Payer: Aetna Commercial |
$890.70
|
| Rate for Payer: Aetna Medicare |
$793.00
|
| Rate for Payer: BCBS Complete |
$457.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,420.21
|
| Rate for Payer: BCN Commercial |
$1,007.65
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Meridian Medicaid |
$457.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,049.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$689.40
|
| Rate for Payer: UHC Exchange |
$689.40
|
| Rate for Payer: UHCCP Medicaid |
$435.80
|
|
|
PR RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 33223
|
| Min. Negotiated Rate |
$258.16 |
| Max. Negotiated Rate |
$1,195.54 |
| Rate for Payer: Aetna Commercial |
$550.24
|
| Rate for Payer: Aetna Medicare |
$678.50
|
| Rate for Payer: BCBS Complete |
$271.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,195.54
|
| Rate for Payer: BCN Commercial |
$592.77
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Meridian Medicaid |
$271.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$642.98
|
| Rate for Payer: Priority Health Narrow Network |
$642.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$555.73
|
| Rate for Payer: UHC Exchange |
$555.73
|
| Rate for Payer: UHCCP Medicaid |
$258.16
|
|
|
PR RELOCATION OF SKIN POCKET FOR PACEMAKER
|
Professional
|
Both
|
$1,151.00
|
|
|
Service Code
|
HCPCS 33222
|
| Min. Negotiated Rate |
$217.69 |
| Max. Negotiated Rate |
$1,036.00 |
| Rate for Payer: Aetna Commercial |
$456.42
|
| Rate for Payer: Aetna Medicare |
$575.50
|
| Rate for Payer: BCBS Complete |
$228.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,036.00
|
| Rate for Payer: BCN Commercial |
$497.47
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Meridian Medicaid |
$228.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$541.40
|
| Rate for Payer: Priority Health Narrow Network |
$541.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$458.79
|
| Rate for Payer: UHC Exchange |
$458.79
|
| Rate for Payer: UHCCP Medicaid |
$217.69
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93297
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$1,891.84 |
| Rate for Payer: Aetna Commercial |
$35.35
|
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,891.84
|
| Rate for Payer: BCN Commercial |
$37.14
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.37
|
| Rate for Payer: Priority Health Narrow Network |
$34.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.68
|
| Rate for Payer: UHC Exchange |
$27.68
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
|
|
PR REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 93299
|
| Min. Negotiated Rate |
$92.80 |
| Max. Negotiated Rate |
$150.80 |
| Rate for Payer: Aetna Medicare |
$116.00
|
| Rate for Payer: BCBS Complete |
$92.80
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.80
|
|
|
PR REM INTERROG PM/LDLS PM <90 D PHYS/QHP
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 93294
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$1,440.67 |
| Rate for Payer: Aetna Commercial |
$40.41
|
| Rate for Payer: Aetna Medicare |
$31.00
|
| Rate for Payer: BCBS Complete |
$19.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,440.67
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Meridian Medicaid |
$19.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.96
|
| Rate for Payer: Priority Health Narrow Network |
$40.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.97
|
| Rate for Payer: UHC Exchange |
$37.97
|
| Rate for Payer: UHCCP Medicaid |
$18.53
|
|
|
PR REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 93296
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$277.89 |
| Rate for Payer: Aetna Commercial |
$31.79
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$277.89
|
| Rate for Payer: BCN Commercial |
$32.75
|
| 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 |
$30.13
|
| Rate for Payer: Priority Health Narrow Network |
$30.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.43
|
| Rate for Payer: UHC Exchange |
$35.43
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 93298
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$1,610.26 |
| Rate for Payer: Aetna Commercial |
$35.35
|
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.26
|
| Rate for Payer: BCN Commercial |
$37.63
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.37
|
| Rate for Payer: Priority Health Narrow Network |
$34.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.66
|
| Rate for Payer: UHC Exchange |
$30.66
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 99454
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$203.92 |
| Rate for Payer: Aetna Commercial |
$58.13
|
| Rate for Payer: Aetna Medicare |
$55.50
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS Trust/PPO |
$203.92
|
| Rate for Payer: BCN Commercial |
$72.33
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| 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 |
$69.50
|
| Rate for Payer: UHC Exchange |
$69.50
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 99453
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$1,867.54 |
| Rate for Payer: Aetna Commercial |
$17.68
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,867.54
|
| Rate for Payer: BCN Commercial |
$27.85
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.92
|
| Rate for Payer: Priority Health Narrow Network |
$26.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.12
|
| Rate for Payer: UHC Exchange |
$21.12
|
|
|
PR REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 93264
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$817.28 |
| Rate for Payer: Aetna Commercial |
$47.30
|
| Rate for Payer: Aetna Medicare |
$50.50
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS Trust/PPO |
$817.28
|
| Rate for Payer: BCN Commercial |
$73.31
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.44
|
| Rate for Payer: Priority Health Narrow Network |
$49.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.74
|
| Rate for Payer: UHC Exchange |
$46.74
|
| Rate for Payer: UHCCP Medicaid |
$22.37
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING 1ST 20 MIN MONTH
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 99457
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$278.41 |
| Rate for Payer: Aetna Commercial |
$31.23
|
| Rate for Payer: Aetna Medicare |
$50.00
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS Trust/PPO |
$278.41
|
| Rate for Payer: BCN Commercial |
$70.37
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.94
|
| Rate for Payer: Priority Health Narrow Network |
$39.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.26
|
| Rate for Payer: UHC Exchange |
$36.26
|
| Rate for Payer: UHCCP Medicaid |
$18.96
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 99458
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$140.53 |
| Rate for Payer: Aetna Commercial |
$31.23
|
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS Trust/PPO |
$140.53
|
| Rate for Payer: BCN Commercial |
$57.17
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.94
|
| Rate for Payer: Priority Health Narrow Network |
$39.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.70
|
| Rate for Payer: UHC Exchange |
$36.70
|
| Rate for Payer: UHCCP Medicaid |
$18.96
|
|
