|
PR SBSQ OBSERVATION CARE/DAY 25 MINUTES
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 99225
|
| Min. Negotiated Rate |
$62.00 |
| Max. Negotiated Rate |
$116.25 |
| Rate for Payer: BCBS Complete |
$62.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
|
|
PR SBSQ OBSERVATION CARE/DAY 35 MINUTES
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 99226
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: BCBS Complete |
$92.40
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.25
|
|
|
PR SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 99493
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$118.84
|
| Rate for Payer: Aetna Medicare |
$88.69
|
| Rate for Payer: BCBS Complete |
$59.93
|
| Rate for Payer: BCBS MAPPO |
$88.69
|
| Rate for Payer: BCN Commercial |
$98.64
|
| Rate for Payer: BCN Medicare Advantage |
$88.69
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$127.71
|
| Rate for Payer: Cofinity Commercial |
$118.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.69
|
| Rate for Payer: Healthscope Commercial |
$97.56
|
| Rate for Payer: Healthscope Whirlpool |
$97.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.12
|
| Rate for Payer: Meridian Medicaid |
$59.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.56
|
| Rate for Payer: Nomi Health Commercial |
$106.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PACE SWMI |
$88.69
|
| Rate for Payer: PHP Medicare Advantage |
$88.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$154.29
|
| Rate for Payer: Priority Health Medicare |
$88.69
|
| Rate for Payer: Priority Health Narrow Network |
$154.29
|
| Rate for Payer: Railroad Medicare Medicare |
$88.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$88.69
|
| Rate for Payer: UHC Exchange |
$112.56
|
| Rate for Payer: UHC Medicaid |
$57.08
|
| Rate for Payer: UHCCP DNSP |
$88.69
|
| Rate for Payer: UHCCP Medicaid |
$57.08
|
|
|
PR SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID
|
Professional
|
Both
|
$2,335.00
|
|
|
Service Code
|
HCPCS 49185
|
| Min. Negotiated Rate |
$67.10 |
| Max. Negotiated Rate |
$1,751.25 |
| Rate for Payer: Aetna Commercial |
$140.54
|
| Rate for Payer: Aetna Medicare |
$104.88
|
| Rate for Payer: BCBS Complete |
$70.45
|
| Rate for Payer: BCBS MAPPO |
$104.88
|
| Rate for Payer: BCN Commercial |
$176.28
|
| Rate for Payer: BCN Medicare Advantage |
$104.88
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cofinity Commercial |
$151.03
|
| Rate for Payer: Cofinity Commercial |
$140.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.88
|
| Rate for Payer: Healthscope Commercial |
$125.86
|
| Rate for Payer: Healthscope Whirlpool |
$125.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.12
|
| Rate for Payer: Meridian Medicaid |
$70.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.37
|
| Rate for Payer: Nomi Health Commercial |
$125.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,751.25
|
| Rate for Payer: PACE SWMI |
$104.88
|
| Rate for Payer: PHP Medicare Advantage |
$104.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$214.80
|
| Rate for Payer: Priority Health Medicare |
$104.88
|
| Rate for Payer: Priority Health Narrow Network |
$214.80
|
| Rate for Payer: Railroad Medicare Medicare |
$104.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.88
|
| Rate for Payer: UHC Exchange |
$213.08
|
| Rate for Payer: UHC Medicaid |
$67.10
|
| Rate for Payer: UHCCP DNSP |
$104.88
|
| Rate for Payer: UHCCP Medicaid |
$67.10
|
|
|
PR SCREENING PAP SMEAR BY PHYS
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS P3001
|
| Min. Negotiated Rate |
$14.96 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Aetna Commercial |
$30.50
|
| Rate for Payer: Aetna Medicare |
$22.76
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCBS MAPPO |
$22.76
|
| Rate for Payer: BCN Commercial |
$37.35
|
| Rate for Payer: BCN Medicare Advantage |
$22.76
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$30.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.76
|
| Rate for Payer: Healthscope Commercial |
$27.31
|
| Rate for Payer: Healthscope Whirlpool |
$27.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.04
|
| Rate for Payer: Nomi Health Commercial |
$27.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.50
|
| Rate for Payer: PACE SWMI |
$22.76
|
| Rate for Payer: PHP Medicare Advantage |
$22.76
|
| Rate for Payer: Priority Health Medicare |
$22.76
|
| Rate for Payer: Railroad Medicare Medicare |
$22.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.76
|
| Rate for Payer: UHC Exchange |
$14.96
|
| Rate for Payer: UHCCP DNSP |
$22.76
|
|
|
PR SCREENING PROCTOSCOPY
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS S0601
|
| Min. Negotiated Rate |
$24.45 |
| Max. Negotiated Rate |
$119.25 |
| Rate for Payer: Aetna Commercial |
$24.45
|
| Rate for Payer: BCBS Complete |
$63.60
|
| Rate for Payer: BCN Commercial |
$67.74
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.25
|
|
|
PR SCREENING TEST PURE TONE AIR ONLY
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 92551
|
| Min. Negotiated Rate |
$12.13 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$12.13
|
| Rate for Payer: BCN Commercial |
$18.92
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17.45
|
| Rate for Payer: Priority Health Narrow Network |
$17.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.60
|
| Rate for Payer: UHC Exchange |
$17.60
|
|
|
PR SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 99173
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$3.23
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCN Commercial |
$4.98
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4.59
|
| Rate for Payer: Priority Health Narrow Network |
$4.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.79
|
| Rate for Payer: UHC Exchange |
$3.79
|
|
|
PR SCR MAMMO BI INCL CAD
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS G0202
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$159.75 |
| Rate for Payer: BCBS Complete |
$85.20
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.75
|
|
|
PR SCROTAL EXPLORATION
|
Professional
|
Both
|
$723.00
|
|
|
Service Code
|
HCPCS 55110
|
| Min. Negotiated Rate |
$231.53 |
| Max. Negotiated Rate |
$680.86 |
| Rate for Payer: Aetna Commercial |
$476.52
|
| Rate for Payer: Aetna Medicare |
$355.61
|
| Rate for Payer: BCBS Complete |
$243.11
|
| Rate for Payer: BCBS MAPPO |
$355.61
|
| Rate for Payer: BCN Commercial |
$588.12
|
| Rate for Payer: BCN Medicare Advantage |
$355.61
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$512.08
|
| Rate for Payer: Cofinity Commercial |
$476.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.61
|
| Rate for Payer: Healthscope Commercial |
$426.73
|
| Rate for Payer: Healthscope Whirlpool |
$426.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.39
|
| Rate for Payer: Meridian Medicaid |
$243.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$391.17
|
| Rate for Payer: Nomi Health Commercial |
$426.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.25
|
| Rate for Payer: PACE SWMI |
$355.61
|
| Rate for Payer: PHP Medicare Advantage |
$355.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$640.65
|
| Rate for Payer: Priority Health Medicare |
$355.61
|
| Rate for Payer: Priority Health Narrow Network |
$640.65
|
| Rate for Payer: Railroad Medicare Medicare |
$355.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$680.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$355.61
|
| Rate for Payer: UHC Exchange |
$680.86
|
| Rate for Payer: UHC Medicaid |
$231.53
|
| Rate for Payer: UHCCP DNSP |
$355.61
|
| Rate for Payer: UHCCP Medicaid |
$231.53
|
|
|
PR SCROTOPLASTY COMPLICATED
|
Professional
|
Both
|
$1,456.00
|
|
|
Service Code
|
HCPCS 55180
|
| Min. Negotiated Rate |
$397.88 |
| Max. Negotiated Rate |
$1,219.64 |
| Rate for Payer: Aetna Commercial |
$822.57
|
| Rate for Payer: Aetna Medicare |
$613.86
|
| Rate for Payer: BCBS Complete |
$417.77
|
| Rate for Payer: BCBS MAPPO |
$613.86
|
| Rate for Payer: BCN Commercial |
$1,034.31
|
| Rate for Payer: BCN Medicare Advantage |
$613.86
|
| Rate for Payer: Cash Price |
$1,164.80
|
| Rate for Payer: Cash Price |
$1,164.80
|
| Rate for Payer: Cofinity Commercial |
$883.96
|
| Rate for Payer: Cofinity Commercial |
$822.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$613.86
|
| Rate for Payer: Healthscope Commercial |
$736.63
|
| Rate for Payer: Healthscope Whirlpool |
$736.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$644.55
|
| Rate for Payer: Meridian Medicaid |
$417.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$675.25
|
| Rate for Payer: Nomi Health Commercial |
$736.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,092.00
|
| Rate for Payer: PACE SWMI |
$613.86
|
| Rate for Payer: PHP Medicare Advantage |
$613.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,126.70
|
| Rate for Payer: Priority Health Medicare |
$613.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,126.70
|
| Rate for Payer: Railroad Medicare Medicare |
$613.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,219.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$613.86
|
| Rate for Payer: UHC Exchange |
$1,219.64
|
| Rate for Payer: UHC Medicaid |
$397.88
|
| Rate for Payer: UHCCP DNSP |
$613.86
|
| Rate for Payer: UHCCP Medicaid |
$397.88
|
|
|
PR SCROTOPLASTY SIMPLE
|
Professional
|
Both
|
$705.00
|
|
|
Service Code
|
HCPCS 55175
|
| Min. Negotiated Rate |
$216.62 |
| Max. Negotiated Rate |
$635.88 |
| Rate for Payer: Aetna Commercial |
$445.11
|
| Rate for Payer: Aetna Medicare |
$332.17
|
| Rate for Payer: BCBS Complete |
$227.45
|
| Rate for Payer: BCBS MAPPO |
$332.17
|
| Rate for Payer: BCN Commercial |
$552.26
|
| Rate for Payer: BCN Medicare Advantage |
$332.17
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cofinity Commercial |
$478.32
|
| Rate for Payer: Cofinity Commercial |
$445.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.17
|
| Rate for Payer: Healthscope Commercial |
$398.60
|
| Rate for Payer: Healthscope Whirlpool |
$398.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.78
|
| Rate for Payer: Meridian Medicaid |
$227.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.39
|
| Rate for Payer: Nomi Health Commercial |
$398.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$528.75
|
| Rate for Payer: PACE SWMI |
$332.17
|
| Rate for Payer: PHP Medicare Advantage |
$332.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$601.59
|
| Rate for Payer: Priority Health Medicare |
$332.17
|
| Rate for Payer: Priority Health Narrow Network |
$601.59
|
| Rate for Payer: Railroad Medicare Medicare |
$332.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$635.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$332.17
|
| Rate for Payer: UHC Exchange |
$635.88
|
| Rate for Payer: UHC Medicaid |
$216.62
|
| Rate for Payer: UHCCP DNSP |
$332.17
|
| Rate for Payer: UHCCP Medicaid |
$216.62
|
|
|
PR SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN
|
Professional
|
Both
|
$2,416.00
|
|
|
Service Code
|
HCPCS 49900
|
| Min. Negotiated Rate |
$510.35 |
| Max. Negotiated Rate |
$1,812.00 |
| Rate for Payer: Aetna Commercial |
$1,055.59
|
| Rate for Payer: Aetna Medicare |
$787.75
|
| Rate for Payer: BCBS Complete |
$535.87
|
| Rate for Payer: BCBS MAPPO |
$787.75
|
| Rate for Payer: BCN Commercial |
$1,247.94
|
| Rate for Payer: BCN Medicare Advantage |
$787.75
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cofinity Commercial |
$1,134.36
|
| Rate for Payer: Cofinity Commercial |
$1,055.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.75
|
| Rate for Payer: Healthscope Commercial |
$945.30
|
| Rate for Payer: Healthscope Whirlpool |
$945.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$827.14
|
| Rate for Payer: Meridian Medicaid |
$535.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$866.52
|
| Rate for Payer: Nomi Health Commercial |
$945.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,812.00
|
| Rate for Payer: PACE SWMI |
$787.75
|
| Rate for Payer: PHP Medicare Advantage |
$787.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$510.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,520.53
|
| Rate for Payer: Priority Health Medicare |
$787.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,520.53
|
| Rate for Payer: Railroad Medicare Medicare |
$787.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,445.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$787.75
|
| Rate for Payer: UHC Exchange |
$1,445.75
|
| Rate for Payer: UHC Medicaid |
$510.35
|
| Rate for Payer: UHCCP DNSP |
$787.75
|
| Rate for Payer: UHCCP Medicaid |
$510.35
|
|
|
PR SECONDARY CLOSURE SURG WOUND/DEHSN XTNSV/COMP
|
Professional
|
Both
|
$1,846.00
|
|
|
Service Code
|
HCPCS 13160
|
| Min. Negotiated Rate |
$472.43 |
| Max. Negotiated Rate |
$1,396.09 |
| Rate for Payer: Aetna Commercial |
$972.37
|
| Rate for Payer: Aetna Medicare |
$725.65
|
| Rate for Payer: BCBS Complete |
$496.05
|
| Rate for Payer: BCBS MAPPO |
$725.65
|
| Rate for Payer: BCN Commercial |
$1,201.13
|
| Rate for Payer: BCN Medicare Advantage |
$725.65
|
| Rate for Payer: Cash Price |
$1,476.80
|
| Rate for Payer: Cash Price |
$1,476.80
|
| Rate for Payer: Cofinity Commercial |
$972.37
|
| Rate for Payer: Cofinity Commercial |
$1,044.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$725.65
|
| Rate for Payer: Healthscope Commercial |
$870.78
|
| Rate for Payer: Healthscope Whirlpool |
$870.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$761.93
|
| Rate for Payer: Meridian Medicaid |
$496.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$798.22
|
| Rate for Payer: Nomi Health Commercial |
$870.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,384.50
|
| Rate for Payer: PACE SWMI |
$725.65
|
| Rate for Payer: PHP Medicare Advantage |
$725.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,099.35
|
| Rate for Payer: Priority Health Medicare |
$725.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,099.35
|
| Rate for Payer: Railroad Medicare Medicare |
$725.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,396.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$725.65
|
| Rate for Payer: UHC Exchange |
$1,396.09
|
| Rate for Payer: UHC Medicaid |
$472.43
|
| Rate for Payer: UHCCP DNSP |
$725.65
|
| Rate for Payer: UHCCP Medicaid |
$472.43
|
|
|
PR SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ
|
Professional
|
Both
|
$4,707.00
|
|
|
Service Code
|
HCPCS 21275
|
| Min. Negotiated Rate |
$487.34 |
| Max. Negotiated Rate |
$3,530.25 |
| Rate for Payer: Aetna Commercial |
$1,000.20
|
| Rate for Payer: Aetna Medicare |
$746.42
|
| Rate for Payer: BCBS Complete |
$511.71
|
| Rate for Payer: BCBS MAPPO |
$746.42
|
| Rate for Payer: BCN Commercial |
$1,272.84
|
| Rate for Payer: BCN Medicare Advantage |
$746.42
|
| Rate for Payer: Cash Price |
$3,765.60
|
| Rate for Payer: Cash Price |
$3,765.60
|
| Rate for Payer: Cofinity Commercial |
$1,074.84
|
| Rate for Payer: Cofinity Commercial |
$1,000.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.42
|
| Rate for Payer: Healthscope Commercial |
$895.70
|
| Rate for Payer: Healthscope Whirlpool |
$895.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.74
|
| Rate for Payer: Meridian Medicaid |
$511.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$821.06
|
| Rate for Payer: Nomi Health Commercial |
$895.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,530.25
|
| Rate for Payer: PACE SWMI |
$746.42
|
| Rate for Payer: PHP Medicare Advantage |
$746.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,360.64
|
| Rate for Payer: Priority Health Medicare |
$746.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,360.64
|
| Rate for Payer: Railroad Medicare Medicare |
$746.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,475.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$746.42
|
| Rate for Payer: UHC Exchange |
$1,475.62
|
| Rate for Payer: UHC Medicaid |
$487.34
|
| Rate for Payer: UHCCP DNSP |
$746.42
|
| Rate for Payer: UHCCP Medicaid |
$487.34
|
|
|
PR SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT
|
Professional
|
Both
|
$6,479.00
|
|
|
Service Code
|
HCPCS 61618
|
| Min. Negotiated Rate |
$777.02 |
| Max. Negotiated Rate |
$4,859.25 |
| Rate for Payer: Aetna Commercial |
$1,620.42
|
| Rate for Payer: Aetna Medicare |
$1,209.27
|
| Rate for Payer: BCBS Complete |
$815.87
|
| Rate for Payer: BCBS MAPPO |
$1,209.27
|
| Rate for Payer: BCN Commercial |
$2,714.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,209.27
|
| Rate for Payer: Cash Price |
$5,183.20
|
| Rate for Payer: Cash Price |
$5,183.20
|
| Rate for Payer: Cofinity Commercial |
$1,741.35
|
| Rate for Payer: Cofinity Commercial |
$1,620.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,209.27
|
| Rate for Payer: Healthscope Commercial |
$1,451.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,451.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,269.73
|
| Rate for Payer: Meridian Medicaid |
$815.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,330.20
|
| Rate for Payer: Nomi Health Commercial |
$1,451.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,859.25
|
| Rate for Payer: PACE SWMI |
$1,209.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,209.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,281.77
|
| Rate for Payer: Priority Health Medicare |
$1,209.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,281.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,209.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,246.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,209.27
|
| Rate for Payer: UHC Exchange |
$2,246.64
|
| Rate for Payer: UHC Medicaid |
$777.02
|
| Rate for Payer: UHCCP DNSP |
$1,209.27
|
| Rate for Payer: UHCCP Medicaid |
$777.02
|
|
|
PR SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL
|
Professional
|
Both
|
$2,644.00
|
|
|
Service Code
|
HCPCS 37186
|
| Min. Negotiated Rate |
$138.88 |
| Max. Negotiated Rate |
$1,983.00 |
| Rate for Payer: Aetna Commercial |
$295.36
|
| Rate for Payer: Aetna Medicare |
$220.42
|
| Rate for Payer: BCBS Complete |
$145.82
|
| Rate for Payer: BCBS MAPPO |
$220.42
|
| Rate for Payer: BCN Commercial |
$356.55
|
| Rate for Payer: BCN Medicare Advantage |
$220.42
|
| Rate for Payer: Cash Price |
$2,115.20
|
| Rate for Payer: Cash Price |
$2,115.20
|
| Rate for Payer: Cofinity Commercial |
$317.40
|
| Rate for Payer: Cofinity Commercial |
$295.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.42
|
| Rate for Payer: Healthscope Commercial |
$264.50
|
| Rate for Payer: Healthscope Whirlpool |
$264.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.44
|
| Rate for Payer: Meridian Medicaid |
$145.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$242.46
|
| Rate for Payer: Nomi Health Commercial |
$264.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,983.00
|
| Rate for Payer: PACE SWMI |
$220.42
|
| Rate for Payer: PHP Medicare Advantage |
$220.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$383.43
|
| Rate for Payer: Priority Health Medicare |
$220.42
|
| Rate for Payer: Priority Health Narrow Network |
$383.43
|
| Rate for Payer: Railroad Medicare Medicare |
$220.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$438.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$220.42
|
| Rate for Payer: UHC Exchange |
$438.55
|
| Rate for Payer: UHC Medicaid |
$138.88
|
| Rate for Payer: UHCCP DNSP |
$220.42
|
| Rate for Payer: UHCCP Medicaid |
$138.88
|
|
|
PR SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP
|
Professional
|
Both
|
$10,237.00
|
|
|
Service Code
|
HCPCS 61619
|
| Min. Negotiated Rate |
$998.33 |
| Max. Negotiated Rate |
$7,677.75 |
| Rate for Payer: Aetna Commercial |
$2,087.25
|
| Rate for Payer: Aetna Medicare |
$1,557.65
|
| Rate for Payer: BCBS Complete |
$1,048.25
|
| Rate for Payer: BCBS MAPPO |
$1,557.65
|
| Rate for Payer: BCN Commercial |
$2,978.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,557.65
|
| Rate for Payer: Cash Price |
$8,189.60
|
| Rate for Payer: Cash Price |
$8,189.60
|
| Rate for Payer: Cofinity Commercial |
$2,243.02
|
| Rate for Payer: Cofinity Commercial |
$2,087.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,557.65
|
| Rate for Payer: Healthscope Commercial |
$1,869.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,869.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,635.53
|
| Rate for Payer: Meridian Medicaid |
$1,048.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,713.41
|
| Rate for Payer: Nomi Health Commercial |
$1,869.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,677.75
|
| Rate for Payer: PACE SWMI |
$1,557.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,557.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$998.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,503.87
|
| Rate for Payer: Priority Health Medicare |
$1,557.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,503.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,557.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,479.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,557.65
|
| Rate for Payer: UHC Exchange |
$2,479.24
|
| Rate for Payer: UHC Medicaid |
$998.33
|
| Rate for Payer: UHCCP DNSP |
$1,557.65
|
| Rate for Payer: UHCCP Medicaid |
$998.33
|
|
|
PR SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 97535
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$41.49
|
| Rate for Payer: Aetna Medicare |
$30.96
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS MAPPO |
$30.96
|
| Rate for Payer: BCN Commercial |
$33.04
|
| Rate for Payer: BCN Medicare Advantage |
$30.96
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$44.58
|
| Rate for Payer: Cofinity Commercial |
$41.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.96
|
| Rate for Payer: Healthscope Commercial |
$37.15
|
| Rate for Payer: Healthscope Whirlpool |
$37.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.06
|
| Rate for Payer: Nomi Health Commercial |
$37.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.50
|
| Rate for Payer: PACE SWMI |
$30.96
|
| Rate for Payer: PHP Medicare Advantage |
$30.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$30.96
|
| Rate for Payer: Priority Health Narrow Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$30.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.96
|
| Rate for Payer: UHC Exchange |
$30.12
|
| Rate for Payer: UHCCP DNSP |
$30.96
|
|
|
PR SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 92060
|
| Min. Negotiated Rate |
$60.64 |
| Max. Negotiated Rate |
$95.12 |
| Rate for Payer: Aetna Commercial |
$81.26
|
| Rate for Payer: Aetna Medicare |
$60.64
|
| Rate for Payer: BCBS MAPPO |
$60.64
|
| Rate for Payer: BCN Commercial |
$95.12
|
| Rate for Payer: BCN Medicare Advantage |
$60.64
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$81.26
|
| Rate for Payer: Cofinity Commercial |
$87.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.64
|
| Rate for Payer: Healthscope Commercial |
$72.77
|
| Rate for Payer: Healthscope Whirlpool |
$72.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.70
|
| Rate for Payer: Nomi Health Commercial |
$72.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: PACE SWMI |
$60.64
|
| Rate for Payer: PHP Medicare Advantage |
$60.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$81.38
|
| Rate for Payer: Priority Health Medicare |
$60.64
|
| Rate for Payer: Priority Health Narrow Network |
$81.38
|
| Rate for Payer: Railroad Medicare Medicare |
$60.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.64
|
| Rate for Payer: UHC Exchange |
$77.57
|
| Rate for Payer: UHCCP DNSP |
$60.64
|
|
|
PR SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF
|
Professional
|
Both
|
$1,875.00
|
|
|
Service Code
|
HCPCS 30520
|
| Min. Negotiated Rate |
$391.07 |
| Max. Negotiated Rate |
$1,406.25 |
| Rate for Payer: Aetna Commercial |
$786.61
|
| Rate for Payer: Aetna Commercial |
$786.61
|
| Rate for Payer: Aetna Medicare |
$587.02
|
| Rate for Payer: Aetna Medicare |
$587.02
|
| Rate for Payer: BCBS Complete |
$410.62
|
| Rate for Payer: BCBS Complete |
$410.62
|
| Rate for Payer: BCBS MAPPO |
$587.02
|
| Rate for Payer: BCBS MAPPO |
$587.02
|
| Rate for Payer: BCN Commercial |
$1,006.42
|
| Rate for Payer: BCN Commercial |
$1,006.42
|
| Rate for Payer: BCN Medicare Advantage |
$587.02
|
| Rate for Payer: BCN Medicare Advantage |
$587.02
|
| Rate for Payer: Cash Price |
$2,605.60
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$2,605.60
|
| Rate for Payer: Cofinity Commercial |
$786.61
|
| Rate for Payer: Cofinity Commercial |
$845.31
|
| Rate for Payer: Cofinity Commercial |
$786.61
|
| Rate for Payer: Cofinity Commercial |
$845.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.02
|
| Rate for Payer: Healthscope Commercial |
$704.42
|
| Rate for Payer: Healthscope Commercial |
$704.42
|
| Rate for Payer: Healthscope Whirlpool |
$704.42
|
| Rate for Payer: Healthscope Whirlpool |
$704.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$616.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$616.37
|
| Rate for Payer: Meridian Medicaid |
$410.62
|
| Rate for Payer: Meridian Medicaid |
$410.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$645.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$645.72
|
| Rate for Payer: Nomi Health Commercial |
$704.42
|
| Rate for Payer: Nomi Health Commercial |
$704.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,406.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,442.75
|
| Rate for Payer: PACE SWMI |
$587.02
|
| Rate for Payer: PACE SWMI |
$587.02
|
| Rate for Payer: PHP Medicare Advantage |
$587.02
|
| Rate for Payer: PHP Medicare Advantage |
$587.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$947.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$947.74
|
| Rate for Payer: Priority Health Medicare |
$587.02
|
| Rate for Payer: Priority Health Medicare |
$587.02
|
| Rate for Payer: Priority Health Narrow Network |
$947.74
|
| Rate for Payer: Priority Health Narrow Network |
$947.74
|
| Rate for Payer: Railroad Medicare Medicare |
$587.02
|
| Rate for Payer: Railroad Medicare Medicare |
$587.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,102.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,102.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$587.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$587.02
|
| Rate for Payer: UHC Exchange |
$1,102.01
|
| Rate for Payer: UHC Exchange |
$1,102.01
|
| Rate for Payer: UHC Medicaid |
$391.07
|
| Rate for Payer: UHC Medicaid |
$391.07
|
| Rate for Payer: UHCCP DNSP |
$587.02
|
| Rate for Payer: UHCCP DNSP |
$587.02
|
| Rate for Payer: UHCCP Medicaid |
$391.07
|
| Rate for Payer: UHCCP Medicaid |
$391.07
|
|
|
PR SEQUESTRECTOMY FOREARM &/WRIST
|
Professional
|
Both
|
$2,325.00
|
|
|
Service Code
|
HCPCS 25145
|
| Min. Negotiated Rate |
$320.35 |
| Max. Negotiated Rate |
$1,743.75 |
| Rate for Payer: Aetna Commercial |
$652.38
|
| Rate for Payer: Aetna Medicare |
$486.85
|
| Rate for Payer: BCBS Complete |
$336.37
|
| Rate for Payer: BCBS MAPPO |
$486.85
|
| Rate for Payer: BCN Commercial |
$803.74
|
| Rate for Payer: BCN Medicare Advantage |
$486.85
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$701.06
|
| Rate for Payer: Cofinity Commercial |
$652.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.85
|
| Rate for Payer: Healthscope Commercial |
$584.22
|
| Rate for Payer: Healthscope Whirlpool |
$584.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.19
|
| Rate for Payer: Meridian Medicaid |
$336.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$535.53
|
| Rate for Payer: Nomi Health Commercial |
$584.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,743.75
|
| Rate for Payer: PACE SWMI |
$486.85
|
| Rate for Payer: PHP Medicare Advantage |
$486.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$859.17
|
| Rate for Payer: Priority Health Medicare |
$486.85
|
| Rate for Payer: Priority Health Narrow Network |
$859.17
|
| Rate for Payer: Railroad Medicare Medicare |
$486.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$901.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$486.85
|
| Rate for Payer: UHC Exchange |
$901.29
|
| Rate for Payer: UHC Medicaid |
$320.35
|
| Rate for Payer: UHCCP DNSP |
$486.85
|
| Rate for Payer: UHCCP Medicaid |
$320.35
|
|
|
PR SEQUESTRECTOMY SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 24134
|
| Min. Negotiated Rate |
$448.37 |
| Max. Negotiated Rate |
$1,715.25 |
| Rate for Payer: Aetna Commercial |
$919.45
|
| Rate for Payer: Aetna Medicare |
$686.16
|
| Rate for Payer: BCBS Complete |
$470.79
|
| Rate for Payer: BCBS MAPPO |
$686.16
|
| Rate for Payer: BCN Commercial |
$1,143.86
|
| Rate for Payer: BCN Medicare Advantage |
$686.16
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$988.07
|
| Rate for Payer: Cofinity Commercial |
$919.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.16
|
| Rate for Payer: Healthscope Commercial |
$823.39
|
| Rate for Payer: Healthscope Whirlpool |
$823.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.47
|
| Rate for Payer: Meridian Medicaid |
$470.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$754.78
|
| Rate for Payer: Nomi Health Commercial |
$823.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,715.25
|
| Rate for Payer: PACE SWMI |
$686.16
|
| Rate for Payer: PHP Medicare Advantage |
$686.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,222.76
|
| Rate for Payer: Priority Health Medicare |
$686.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,222.76
|
| Rate for Payer: Railroad Medicare Medicare |
$686.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,304.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$686.16
|
| Rate for Payer: UHC Exchange |
$1,304.58
|
| Rate for Payer: UHC Medicaid |
$448.37
|
| Rate for Payer: UHCCP DNSP |
$686.16
|
| Rate for Payer: UHCCP Medicaid |
$448.37
|
|
|
PR SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 99050
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$23.50
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCN Commercial |
$20.37
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$24.80
|
| Rate for Payer: Priority Health Narrow Network |
$24.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.00
|
| Rate for Payer: UHC Exchange |
$28.00
|
|
|
PR SESAMOIDECTOMY FIRST TOE SPX
|
Professional
|
Both
|
$916.00
|
|
|
Service Code
|
HCPCS 28315
|
| Min. Negotiated Rate |
$198.30 |
| Max. Negotiated Rate |
$687.00 |
| Rate for Payer: Aetna Commercial |
$404.67
|
| Rate for Payer: Aetna Medicare |
$301.99
|
| Rate for Payer: BCBS Complete |
$208.22
|
| Rate for Payer: BCBS MAPPO |
$301.99
|
| Rate for Payer: BCN Commercial |
$496.98
|
| Rate for Payer: BCN Medicare Advantage |
$301.99
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cofinity Commercial |
$434.87
|
| Rate for Payer: Cofinity Commercial |
$404.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.99
|
| Rate for Payer: Healthscope Commercial |
$362.39
|
| Rate for Payer: Healthscope Whirlpool |
$362.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.09
|
| Rate for Payer: Meridian Medicaid |
$208.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$332.19
|
| Rate for Payer: Nomi Health Commercial |
$362.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$687.00
|
| Rate for Payer: PACE SWMI |
$301.99
|
| Rate for Payer: PHP Medicare Advantage |
$301.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$531.27
|
| Rate for Payer: Priority Health Medicare |
$301.99
|
| Rate for Payer: Priority Health Narrow Network |
$531.27
|
| Rate for Payer: Railroad Medicare Medicare |
$301.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$568.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$301.99
|
| Rate for Payer: UHC Exchange |
$568.34
|
| Rate for Payer: UHC Medicaid |
$198.30
|
| Rate for Payer: UHCCP DNSP |
$301.99
|
| Rate for Payer: UHCCP Medicaid |
$198.30
|
|
