|
PR SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,730.00
|
|
|
Service Code
|
HCPCS 26185
|
| Min. Negotiated Rate |
$349.11 |
| Max. Negotiated Rate |
$1,297.50 |
| Rate for Payer: Aetna Commercial |
$707.47
|
| Rate for Payer: Aetna Medicare |
$527.96
|
| Rate for Payer: BCBS Complete |
$366.57
|
| Rate for Payer: BCBS MAPPO |
$527.96
|
| Rate for Payer: BCN Commercial |
$863.01
|
| Rate for Payer: BCN Medicare Advantage |
$527.96
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cofinity Commercial |
$760.26
|
| Rate for Payer: Cofinity Commercial |
$707.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.96
|
| Rate for Payer: Healthscope Commercial |
$633.55
|
| Rate for Payer: Healthscope Whirlpool |
$633.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.36
|
| Rate for Payer: Meridian Medicaid |
$366.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$580.76
|
| Rate for Payer: Nomi Health Commercial |
$633.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,297.50
|
| Rate for Payer: PACE SWMI |
$527.96
|
| Rate for Payer: PHP Medicare Advantage |
$527.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$922.52
|
| Rate for Payer: Priority Health Medicare |
$527.96
|
| Rate for Payer: Priority Health Narrow Network |
$922.52
|
| Rate for Payer: Railroad Medicare Medicare |
$527.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$953.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$527.96
|
| Rate for Payer: UHC Exchange |
$953.99
|
| Rate for Payer: UHC Medicaid |
$349.11
|
| Rate for Payer: UHCCP DNSP |
$527.96
|
| Rate for Payer: UHCCP Medicaid |
$349.11
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 45335
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$502.50 |
| Rate for Payer: Aetna Commercial |
$81.70
|
| Rate for Payer: Aetna Medicare |
$60.97
|
| Rate for Payer: BCBS Complete |
$41.82
|
| Rate for Payer: BCBS MAPPO |
$60.97
|
| Rate for Payer: BCN Commercial |
$100.60
|
| Rate for Payer: BCN Medicare Advantage |
$60.97
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cofinity Commercial |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$81.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.97
|
| Rate for Payer: Healthscope Commercial |
$73.16
|
| Rate for Payer: Healthscope Whirlpool |
$73.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.02
|
| Rate for Payer: Meridian Medicaid |
$41.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.07
|
| Rate for Payer: Nomi Health Commercial |
$73.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$502.50
|
| Rate for Payer: PACE SWMI |
$60.97
|
| Rate for Payer: PHP Medicare Advantage |
$60.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$122.57
|
| Rate for Payer: Priority Health Medicare |
$60.97
|
| Rate for Payer: Priority Health Narrow Network |
$122.57
|
| Rate for Payer: Railroad Medicare Medicare |
$60.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.97
|
| Rate for Payer: UHC Exchange |
$115.99
|
| Rate for Payer: UHC Medicaid |
$39.83
|
| Rate for Payer: UHCCP DNSP |
$60.97
|
| Rate for Payer: UHCCP Medicaid |
$39.83
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$774.00
|
|
|
Service Code
|
HCPCS 45338
|
| Min. Negotiated Rate |
$69.44 |
| Max. Negotiated Rate |
$580.50 |
| Rate for Payer: Aetna Commercial |
$143.42
|
| Rate for Payer: Aetna Medicare |
$107.03
|
| Rate for Payer: BCBS Complete |
$72.91
|
| Rate for Payer: BCBS MAPPO |
$107.03
|
| Rate for Payer: BCN Commercial |
$178.28
|
| Rate for Payer: BCN Medicare Advantage |
$107.03
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$154.12
|
| Rate for Payer: Cofinity Commercial |
$143.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.03
|
| Rate for Payer: Healthscope Commercial |
$128.44
|
| Rate for Payer: Healthscope Whirlpool |
$128.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.38
|
| Rate for Payer: Meridian Medicaid |
$72.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.73
|
| Rate for Payer: Nomi Health Commercial |
$128.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.50
|
| Rate for Payer: PACE SWMI |
$107.03
|
| Rate for Payer: PHP Medicare Advantage |
$107.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$217.22
|
| Rate for Payer: Priority Health Medicare |
$107.03
|
| Rate for Payer: Priority Health Narrow Network |
$217.22
|
| Rate for Payer: Railroad Medicare Medicare |
$107.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$211.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.03
|
| Rate for Payer: UHC Exchange |
$211.69
|
| Rate for Payer: UHC Medicaid |
$69.44
|
| Rate for Payer: UHCCP DNSP |
$107.03
|
| Rate for Payer: UHCCP Medicaid |
$69.44
|
|
|
PR SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE
|
Professional
|
Both
|
$624.00
|
|
|
Service Code
|
HCPCS 45337
|
| Min. Negotiated Rate |
$63.69 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna Commercial |
$132.49
|
| Rate for Payer: Aetna Medicare |
$98.87
|
| Rate for Payer: BCBS Complete |
$66.87
|
| Rate for Payer: BCBS MAPPO |
$98.87
|
| Rate for Payer: BCN Commercial |
$168.81
|
| Rate for Payer: BCN Medicare Advantage |
$98.87
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cofinity Commercial |
$142.37
|
| Rate for Payer: Cofinity Commercial |
$132.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.87
|
| Rate for Payer: Healthscope Commercial |
$118.64
|
| Rate for Payer: Healthscope Whirlpool |
$118.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.81
|
| Rate for Payer: Meridian Medicaid |
$66.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.76
|
| Rate for Payer: Nomi Health Commercial |
$118.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.00
|
| Rate for Payer: PACE SWMI |
$98.87
|
| Rate for Payer: PHP Medicare Advantage |
$98.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$205.68
|
| Rate for Payer: Priority Health Medicare |
$98.87
|
| Rate for Payer: Priority Health Narrow Network |
$205.68
|
| Rate for Payer: Railroad Medicare Medicare |
$98.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.87
|
| Rate for Payer: UHC Exchange |
$204.54
|
| Rate for Payer: UHC Medicaid |
$63.69
|
| Rate for Payer: UHCCP DNSP |
$98.87
|
| Rate for Payer: UHCCP Medicaid |
$63.69
|
|
|
PR SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 45349
|
| Min. Negotiated Rate |
$111.83 |
| Max. Negotiated Rate |
$355.56 |
| Rate for Payer: Aetna Commercial |
$231.66
|
| Rate for Payer: Aetna Medicare |
$172.88
|
| Rate for Payer: BCBS Complete |
$117.42
|
| Rate for Payer: BCBS MAPPO |
$172.88
|
| Rate for Payer: BCN Commercial |
$291.81
|
| Rate for Payer: BCN Medicare Advantage |
$172.88
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Commercial |
$248.95
|
| Rate for Payer: Cofinity Commercial |
$231.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.88
|
| Rate for Payer: Healthscope Commercial |
$207.46
|
| Rate for Payer: Healthscope Whirlpool |
$207.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.52
|
| Rate for Payer: Meridian Medicaid |
$117.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$190.17
|
| Rate for Payer: Nomi Health Commercial |
$207.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.00
|
| Rate for Payer: PACE SWMI |
$172.88
|
| Rate for Payer: PHP Medicare Advantage |
$172.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$355.56
|
| Rate for Payer: Priority Health Medicare |
$172.88
|
| Rate for Payer: Priority Health Narrow Network |
$355.56
|
| Rate for Payer: Railroad Medicare Medicare |
$172.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$350.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$172.88
|
| Rate for Payer: UHC Exchange |
$350.09
|
| Rate for Payer: UHC Medicaid |
$111.83
|
| Rate for Payer: UHCCP DNSP |
$172.88
|
| Rate for Payer: UHCCP Medicaid |
$111.83
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 11310
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Aetna Commercial |
$48.25
|
| Rate for Payer: Aetna Medicare |
$36.01
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS MAPPO |
$36.01
|
| Rate for Payer: BCN Commercial |
$53.01
|
| Rate for Payer: BCN Medicare Advantage |
$36.01
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$51.85
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.01
|
| Rate for Payer: Healthscope Commercial |
$43.21
|
| Rate for Payer: Healthscope Whirlpool |
$43.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.81
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.61
|
| Rate for Payer: Nomi Health Commercial |
$43.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.50
|
| Rate for Payer: PACE SWMI |
$36.01
|
| Rate for Payer: PHP Medicare Advantage |
$36.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$61.53
|
| Rate for Payer: Priority Health Medicare |
$36.01
|
| Rate for Payer: Priority Health Narrow Network |
$61.53
|
| Rate for Payer: Railroad Medicare Medicare |
$36.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.01
|
| Rate for Payer: UHC Exchange |
$81.75
|
| Rate for Payer: UHC Medicaid |
$23.22
|
| Rate for Payer: UHCCP DNSP |
$36.01
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 11313
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$237.00 |
| Rate for Payer: Aetna Commercial |
$102.43
|
| Rate for Payer: Aetna Medicare |
$76.44
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS MAPPO |
$76.44
|
| Rate for Payer: BCN Commercial |
$112.31
|
| Rate for Payer: BCN Medicare Advantage |
$76.44
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$110.07
|
| Rate for Payer: Cofinity Commercial |
$102.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.44
|
| Rate for Payer: Healthscope Commercial |
$91.73
|
| Rate for Payer: Healthscope Whirlpool |
$91.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.26
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.08
|
| Rate for Payer: Nomi Health Commercial |
$91.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.00
|
| Rate for Payer: PACE SWMI |
$76.44
|
| Rate for Payer: PHP Medicare Advantage |
$76.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$130.35
|
| Rate for Payer: Priority Health Medicare |
$76.44
|
| Rate for Payer: Priority Health Narrow Network |
$130.35
|
| Rate for Payer: Railroad Medicare Medicare |
$76.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.44
|
| Rate for Payer: UHC Exchange |
$171.95
|
| Rate for Payer: UHC Medicaid |
$49.20
|
| Rate for Payer: UHCCP DNSP |
$76.44
|
| Rate for Payer: UHCCP Medicaid |
$49.20
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 11305
|
| Min. Negotiated Rate |
$20.87 |
| Max. Negotiated Rate |
$124.50 |
| Rate for Payer: Aetna Commercial |
$43.76
|
| Rate for Payer: Aetna Medicare |
$32.66
|
| Rate for Payer: BCBS Complete |
$21.91
|
| Rate for Payer: BCBS MAPPO |
$32.66
|
| Rate for Payer: BCN Commercial |
$43.59
|
| Rate for Payer: BCN Medicare Advantage |
$32.66
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$47.03
|
| Rate for Payer: Cofinity Commercial |
$43.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.66
|
| Rate for Payer: Healthscope Commercial |
$39.19
|
| Rate for Payer: Healthscope Whirlpool |
$39.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.29
|
| Rate for Payer: Meridian Medicaid |
$21.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.93
|
| Rate for Payer: Nomi Health Commercial |
$39.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.50
|
| Rate for Payer: PACE SWMI |
$32.66
|
| Rate for Payer: PHP Medicare Advantage |
$32.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$50.59
|
| Rate for Payer: Priority Health Medicare |
$32.66
|
| Rate for Payer: Priority Health Narrow Network |
$50.59
|
| Rate for Payer: Railroad Medicare Medicare |
$32.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.66
|
| Rate for Payer: UHC Exchange |
$69.62
|
| Rate for Payer: UHC Medicaid |
$20.87
|
| Rate for Payer: UHCCP DNSP |
$32.66
|
| Rate for Payer: UHCCP Medicaid |
$20.87
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 11306
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$154.50 |
| Rate for Payer: Aetna Commercial |
$54.28
|
| Rate for Payer: Aetna Medicare |
$40.51
|
| Rate for Payer: BCBS Complete |
$27.29
|
| Rate for Payer: BCBS MAPPO |
$40.51
|
| Rate for Payer: BCN Commercial |
$56.94
|
| Rate for Payer: BCN Medicare Advantage |
$40.51
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$58.33
|
| Rate for Payer: Cofinity Commercial |
$54.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.51
|
| Rate for Payer: Healthscope Commercial |
$48.61
|
| Rate for Payer: Healthscope Whirlpool |
$48.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.54
|
| Rate for Payer: Meridian Medicaid |
$27.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.56
|
| Rate for Payer: Nomi Health Commercial |
$48.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$154.50
|
| Rate for Payer: PACE SWMI |
$40.51
|
| Rate for Payer: PHP Medicare Advantage |
$40.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.08
|
| Rate for Payer: Priority Health Medicare |
$40.51
|
| Rate for Payer: Priority Health Narrow Network |
$66.08
|
| Rate for Payer: Railroad Medicare Medicare |
$40.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.51
|
| Rate for Payer: UHC Exchange |
$88.91
|
| Rate for Payer: UHC Medicaid |
$25.99
|
| Rate for Payer: UHCCP DNSP |
$40.51
|
| Rate for Payer: UHCCP Medicaid |
$25.99
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 11307
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$183.00 |
| Rate for Payer: Aetna Commercial |
$68.55
|
| Rate for Payer: Aetna Medicare |
$51.16
|
| Rate for Payer: BCBS Complete |
$34.44
|
| Rate for Payer: BCBS MAPPO |
$51.16
|
| Rate for Payer: BCN Commercial |
$72.26
|
| Rate for Payer: BCN Medicare Advantage |
$51.16
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$73.67
|
| Rate for Payer: Cofinity Commercial |
$68.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.16
|
| Rate for Payer: Healthscope Commercial |
$61.39
|
| Rate for Payer: Healthscope Whirlpool |
$61.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.72
|
| Rate for Payer: Meridian Medicaid |
$34.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.28
|
| Rate for Payer: Nomi Health Commercial |
$61.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.00
|
| Rate for Payer: PACE SWMI |
$51.16
|
| Rate for Payer: PHP Medicare Advantage |
$51.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$83.87
|
| Rate for Payer: Priority Health Medicare |
$51.16
|
| Rate for Payer: Priority Health Narrow Network |
$83.87
|
| Rate for Payer: Railroad Medicare Medicare |
$51.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.16
|
| Rate for Payer: UHC Exchange |
$114.44
|
| Rate for Payer: UHC Medicaid |
$32.80
|
| Rate for Payer: UHCCP DNSP |
$51.16
|
| Rate for Payer: UHCCP Medicaid |
$32.80
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 11308
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$194.25 |
| Rate for Payer: Aetna Commercial |
$79.93
|
| Rate for Payer: Aetna Medicare |
$59.65
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$59.65
|
| Rate for Payer: BCN Commercial |
$80.90
|
| Rate for Payer: BCN Medicare Advantage |
$59.65
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$85.90
|
| Rate for Payer: Cofinity Commercial |
$79.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.65
|
| Rate for Payer: Healthscope Commercial |
$71.58
|
| Rate for Payer: Healthscope Whirlpool |
$71.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.63
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.61
|
| Rate for Payer: Nomi Health Commercial |
$71.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.25
|
| Rate for Payer: PACE SWMI |
$59.65
|
| Rate for Payer: PHP Medicare Advantage |
$59.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.89
|
| Rate for Payer: Priority Health Medicare |
$59.65
|
| Rate for Payer: Priority Health Narrow Network |
$93.89
|
| Rate for Payer: Railroad Medicare Medicare |
$59.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.65
|
| Rate for Payer: UHC Exchange |
$129.66
|
| Rate for Payer: UHC Medicaid |
$38.13
|
| Rate for Payer: UHCCP DNSP |
$59.65
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
PR SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 11300
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$124.50 |
| Rate for Payer: Aetna Commercial |
$36.80
|
| Rate for Payer: Aetna Medicare |
$27.46
|
| Rate for Payer: BCBS Complete |
$18.56
|
| Rate for Payer: BCBS MAPPO |
$27.46
|
| Rate for Payer: BCN Commercial |
$39.66
|
| Rate for Payer: BCN Medicare Advantage |
$27.46
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$39.54
|
| Rate for Payer: Cofinity Commercial |
$36.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.46
|
| Rate for Payer: Healthscope Commercial |
$32.95
|
| Rate for Payer: Healthscope Whirlpool |
$32.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.83
|
| Rate for Payer: Meridian Medicaid |
$18.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.21
|
| Rate for Payer: Nomi Health Commercial |
$32.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.50
|
| Rate for Payer: PACE SWMI |
$27.46
|
| Rate for Payer: PHP Medicare Advantage |
$27.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.03
|
| Rate for Payer: Priority Health Medicare |
$27.46
|
| Rate for Payer: Priority Health Narrow Network |
$46.03
|
| Rate for Payer: Railroad Medicare Medicare |
$27.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.46
|
| Rate for Payer: UHC Exchange |
$60.40
|
| Rate for Payer: UHC Medicaid |
$17.68
|
| Rate for Payer: UHCCP DNSP |
$27.46
|
| Rate for Payer: UHCCP Medicaid |
$17.68
|
|
|
PR SHOE LIFTS ELEVATION HEEL /I
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS L3334
|
| Min. Negotiated Rate |
$15.28 |
| Max. Negotiated Rate |
$67.49 |
| Rate for Payer: Aetna Commercial |
$62.81
|
| Rate for Payer: Aetna Medicare |
$46.87
|
| Rate for Payer: BCBS Complete |
$26.80
|
| Rate for Payer: BCBS MAPPO |
$46.87
|
| Rate for Payer: BCN Commercial |
$44.87
|
| Rate for Payer: BCN Medicare Advantage |
$46.87
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$67.49
|
| Rate for Payer: Cofinity Commercial |
$62.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.87
|
| Rate for Payer: Healthscope Commercial |
$56.24
|
| Rate for Payer: Healthscope Whirlpool |
$56.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.56
|
| Rate for Payer: Nomi Health Commercial |
$56.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.25
|
| Rate for Payer: PACE SWMI |
$46.87
|
| Rate for Payer: PHP Medicare Advantage |
$46.87
|
| Rate for Payer: Priority Health Medicare |
$46.87
|
| Rate for Payer: Railroad Medicare Medicare |
$46.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.87
|
| Rate for Payer: UHC Exchange |
$15.28
|
| Rate for Payer: UHCCP DNSP |
$46.87
|
|
|
PR SHORTENING TENDON EXTENSOR HAND/FINGER EACH
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 26477
|
| Min. Negotiated Rate |
$391.49 |
| Max. Negotiated Rate |
$1,014.63 |
| Rate for Payer: Aetna Commercial |
$780.84
|
| Rate for Payer: Aetna Medicare |
$582.72
|
| Rate for Payer: BCBS Complete |
$411.06
|
| Rate for Payer: BCBS MAPPO |
$582.72
|
| Rate for Payer: BCN Commercial |
$948.65
|
| Rate for Payer: BCN Medicare Advantage |
$582.72
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cofinity Commercial |
$839.12
|
| Rate for Payer: Cofinity Commercial |
$780.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$582.72
|
| Rate for Payer: Healthscope Commercial |
$699.26
|
| Rate for Payer: Healthscope Whirlpool |
$699.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$611.86
|
| Rate for Payer: Meridian Medicaid |
$411.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$640.99
|
| Rate for Payer: Nomi Health Commercial |
$699.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$933.00
|
| Rate for Payer: PACE SWMI |
$582.72
|
| Rate for Payer: PHP Medicare Advantage |
$582.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,014.08
|
| Rate for Payer: Priority Health Medicare |
$582.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,014.08
|
| Rate for Payer: Railroad Medicare Medicare |
$582.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$582.72
|
| Rate for Payer: UHC Exchange |
$1,014.63
|
| Rate for Payer: UHC Medicaid |
$391.49
|
| Rate for Payer: UHCCP DNSP |
$582.72
|
| Rate for Payer: UHCCP Medicaid |
$391.49
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 95926
|
| Min. Negotiated Rate |
$126.02 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$168.87
|
| Rate for Payer: Aetna Medicare |
$126.02
|
| Rate for Payer: BCBS MAPPO |
$126.02
|
| Rate for Payer: BCN Commercial |
$209.65
|
| Rate for Payer: BCN Medicare Advantage |
$126.02
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$168.87
|
| Rate for Payer: Cofinity Commercial |
$181.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.02
|
| Rate for Payer: Healthscope Commercial |
$151.22
|
| Rate for Payer: Healthscope Whirlpool |
$151.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$138.62
|
| Rate for Payer: Nomi Health Commercial |
$151.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$126.02
|
| Rate for Payer: PHP Medicare Advantage |
$126.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$193.34
|
| Rate for Payer: Priority Health Medicare |
$126.02
|
| Rate for Payer: Priority Health Narrow Network |
$193.34
|
| Rate for Payer: Railroad Medicare Medicare |
$126.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$202.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.02
|
| Rate for Payer: UHC Exchange |
$202.76
|
| Rate for Payer: UHCCP DNSP |
$126.02
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 95927
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$263.44 |
| Rate for Payer: Aetna Commercial |
$210.63
|
| Rate for Payer: Aetna Commercial |
$210.63
|
| Rate for Payer: Aetna Medicare |
$157.19
|
| Rate for Payer: Aetna Medicare |
$157.19
|
| Rate for Payer: BCBS MAPPO |
$157.19
|
| Rate for Payer: BCBS MAPPO |
$157.19
|
| Rate for Payer: BCN Commercial |
$263.44
|
| Rate for Payer: BCN Commercial |
$263.44
|
| Rate for Payer: BCN Medicare Advantage |
$157.19
|
| Rate for Payer: BCN Medicare Advantage |
$157.19
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$226.35
|
| Rate for Payer: Cofinity Commercial |
$210.63
|
| Rate for Payer: Cofinity Commercial |
$226.35
|
| Rate for Payer: Cofinity Commercial |
$210.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.19
|
| Rate for Payer: Healthscope Commercial |
$188.63
|
| Rate for Payer: Healthscope Commercial |
$188.63
|
| Rate for Payer: Healthscope Whirlpool |
$188.63
|
| Rate for Payer: Healthscope Whirlpool |
$188.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.91
|
| Rate for Payer: Nomi Health Commercial |
$188.63
|
| Rate for Payer: Nomi Health Commercial |
$188.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.75
|
| Rate for Payer: PACE SWMI |
$157.19
|
| Rate for Payer: PACE SWMI |
$157.19
|
| Rate for Payer: PHP Medicare Advantage |
$157.19
|
| Rate for Payer: PHP Medicare Advantage |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$242.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$242.94
|
| Rate for Payer: Priority Health Medicare |
$157.19
|
| Rate for Payer: Priority Health Medicare |
$157.19
|
| Rate for Payer: Priority Health Narrow Network |
$242.94
|
| Rate for Payer: Priority Health Narrow Network |
$242.94
|
| Rate for Payer: Railroad Medicare Medicare |
$157.19
|
| Rate for Payer: Railroad Medicare Medicare |
$157.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$202.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$202.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$157.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$157.19
|
| Rate for Payer: UHC Exchange |
$202.28
|
| Rate for Payer: UHC Exchange |
$202.28
|
| Rate for Payer: UHCCP DNSP |
$157.19
|
| Rate for Payer: UHCCP DNSP |
$157.19
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS
|
Professional
|
Both
|
$337.00
|
|
|
Service Code
|
HCPCS 95925
|
| Min. Negotiated Rate |
$140.42 |
| Max. Negotiated Rate |
$252.75 |
| Rate for Payer: Aetna Commercial |
$188.16
|
| Rate for Payer: Aetna Medicare |
$140.42
|
| Rate for Payer: BCBS MAPPO |
$140.42
|
| Rate for Payer: BCN Commercial |
$229.08
|
| Rate for Payer: BCN Medicare Advantage |
$140.42
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cofinity Commercial |
$188.16
|
| Rate for Payer: Cofinity Commercial |
$202.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.42
|
| Rate for Payer: Healthscope Commercial |
$168.50
|
| Rate for Payer: Healthscope Whirlpool |
$168.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.46
|
| Rate for Payer: Nomi Health Commercial |
$168.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.75
|
| Rate for Payer: PACE SWMI |
$140.42
|
| Rate for Payer: PHP Medicare Advantage |
$140.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$211.25
|
| Rate for Payer: Priority Health Medicare |
$140.42
|
| Rate for Payer: Priority Health Narrow Network |
$211.25
|
| Rate for Payer: Railroad Medicare Medicare |
$140.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$212.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.42
|
| Rate for Payer: UHC Exchange |
$212.91
|
| Rate for Payer: UHCCP DNSP |
$140.42
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 95938
|
| Min. Negotiated Rate |
$94.50 |
| Max. Negotiated Rate |
$556.24 |
| Rate for Payer: Aetna Commercial |
$493.68
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: BCBS MAPPO |
$368.42
|
| Rate for Payer: BCN Commercial |
$556.24
|
| Rate for Payer: BCN Medicare Advantage |
$368.42
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$493.68
|
| Rate for Payer: Cofinity Commercial |
$530.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.42
|
| Rate for Payer: Healthscope Commercial |
$442.10
|
| Rate for Payer: Healthscope Whirlpool |
$442.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$405.26
|
| Rate for Payer: Nomi Health Commercial |
$442.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: PACE SWMI |
$368.42
|
| Rate for Payer: PHP Medicare Advantage |
$368.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$512.98
|
| Rate for Payer: Priority Health Medicare |
$368.42
|
| Rate for Payer: Priority Health Narrow Network |
$512.98
|
| Rate for Payer: Railroad Medicare Medicare |
$368.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$530.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$368.42
|
| Rate for Payer: UHC Exchange |
$530.01
|
| Rate for Payer: UHCCP DNSP |
$368.42
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 11311
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$143.25 |
| Rate for Payer: Aetna Commercial |
$67.35
|
| Rate for Payer: Aetna Medicare |
$50.26
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS MAPPO |
$50.26
|
| Rate for Payer: BCN Commercial |
$73.83
|
| Rate for Payer: BCN Medicare Advantage |
$50.26
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$72.37
|
| Rate for Payer: Cofinity Commercial |
$67.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$60.31
|
| Rate for Payer: Healthscope Whirlpool |
$60.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.77
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.29
|
| Rate for Payer: Nomi Health Commercial |
$60.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.25
|
| Rate for Payer: PACE SWMI |
$50.26
|
| Rate for Payer: PHP Medicare Advantage |
$50.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$85.68
|
| Rate for Payer: Priority Health Medicare |
$50.26
|
| Rate for Payer: Priority Health Narrow Network |
$85.68
|
| Rate for Payer: Railroad Medicare Medicare |
$50.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.26
|
| Rate for Payer: UHC Exchange |
$111.60
|
| Rate for Payer: UHC Medicaid |
$32.38
|
| Rate for Payer: UHCCP DNSP |
$50.26
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 11312
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$205.50 |
| Rate for Payer: Aetna Commercial |
$80.16
|
| Rate for Payer: Aetna Medicare |
$59.82
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$59.82
|
| Rate for Payer: BCN Commercial |
$87.57
|
| Rate for Payer: BCN Medicare Advantage |
$59.82
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cofinity Commercial |
$86.14
|
| Rate for Payer: Cofinity Commercial |
$80.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.82
|
| Rate for Payer: Healthscope Commercial |
$71.78
|
| Rate for Payer: Healthscope Whirlpool |
$71.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.81
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.80
|
| Rate for Payer: Nomi Health Commercial |
$71.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.50
|
| Rate for Payer: PACE SWMI |
$59.82
|
| Rate for Payer: PHP Medicare Advantage |
$59.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.64
|
| Rate for Payer: Priority Health Medicare |
$59.82
|
| Rate for Payer: Priority Health Narrow Network |
$101.64
|
| Rate for Payer: Railroad Medicare Medicare |
$59.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.82
|
| Rate for Payer: UHC Exchange |
$132.31
|
| Rate for Payer: UHC Medicaid |
$38.55
|
| Rate for Payer: UHCCP DNSP |
$59.82
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 11301
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$55.27
|
| Rate for Payer: Aetna Medicare |
$41.25
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$41.25
|
| Rate for Payer: BCN Commercial |
$60.48
|
| Rate for Payer: BCN Medicare Advantage |
$41.25
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$59.40
|
| Rate for Payer: Cofinity Commercial |
$55.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.25
|
| Rate for Payer: Healthscope Commercial |
$49.50
|
| Rate for Payer: Healthscope Whirlpool |
$49.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.31
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.38
|
| Rate for Payer: Nomi Health Commercial |
$49.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.00
|
| Rate for Payer: PACE SWMI |
$41.25
|
| Rate for Payer: PHP Medicare Advantage |
$41.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$70.19
|
| Rate for Payer: Priority Health Medicare |
$41.25
|
| Rate for Payer: Priority Health Narrow Network |
$70.19
|
| Rate for Payer: Railroad Medicare Medicare |
$41.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.25
|
| Rate for Payer: UHC Exchange |
$91.47
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP DNSP |
$41.25
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 11301
|
| Hospital Charge Code |
11301
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$55.27
|
| Rate for Payer: Aetna Medicare |
$41.25
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$41.25
|
| Rate for Payer: BCN Commercial |
$60.48
|
| Rate for Payer: BCN Medicare Advantage |
$41.25
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$59.40
|
| Rate for Payer: Cofinity Commercial |
$55.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.25
|
| Rate for Payer: Healthscope Commercial |
$49.50
|
| Rate for Payer: Healthscope Whirlpool |
$49.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.31
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.38
|
| Rate for Payer: Nomi Health Commercial |
$49.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.00
|
| Rate for Payer: PACE SWMI |
$41.25
|
| Rate for Payer: PHP Medicare Advantage |
$41.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$70.19
|
| Rate for Payer: Priority Health Medicare |
$41.25
|
| Rate for Payer: Priority Health Narrow Network |
$70.19
|
| Rate for Payer: Railroad Medicare Medicare |
$41.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.25
|
| Rate for Payer: UHC Exchange |
$91.47
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP DNSP |
$41.25
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$204.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$249.89 |
| Rate for Payer: Aetna Commercial |
$183.60
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$197.88
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$168.20
|
| Rate for Payer: BCN Commercial |
$168.20
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$191.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$197.88
|
| Rate for Payer: Healthscope Whirlpool |
$204.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$183.60
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.40
|
| Rate for Payer: Nomi Health Commercial |
$167.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.00
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$178.74
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$143.00
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$153.00 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: Aetna Commercial |
$183.60
|
| Rate for Payer: ASR ASR |
$197.88
|
| Rate for Payer: BCBS Trust/PPO |
$167.52
|
| Rate for Payer: BCN Commercial |
$167.52
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$191.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Healthscope Commercial |
$197.88
|
| Rate for Payer: Healthscope Whirlpool |
$204.00
|
| Rate for Payer: Mclaren Commercial |
$183.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.40
|
| Rate for Payer: Nomi Health Commercial |
$167.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.00
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 11303
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$198.75 |
| Rate for Payer: Aetna Commercial |
$76.70
|
| Rate for Payer: Aetna Medicare |
$57.24
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS MAPPO |
$57.24
|
| Rate for Payer: BCN Commercial |
$84.04
|
| Rate for Payer: BCN Medicare Advantage |
$57.24
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cofinity Commercial |
$82.43
|
| Rate for Payer: Cofinity Commercial |
$76.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.24
|
| Rate for Payer: Healthscope Commercial |
$68.69
|
| Rate for Payer: Healthscope Whirlpool |
$68.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.10
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.96
|
| Rate for Payer: Nomi Health Commercial |
$68.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.75
|
| Rate for Payer: PACE SWMI |
$57.24
|
| Rate for Payer: PHP Medicare Advantage |
$57.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$97.54
|
| Rate for Payer: Priority Health Medicare |
$57.24
|
| Rate for Payer: Priority Health Narrow Network |
$97.54
|
| Rate for Payer: Railroad Medicare Medicare |
$57.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.24
|
| Rate for Payer: UHC Exchange |
$126.24
|
| Rate for Payer: UHC Medicaid |
$36.85
|
| Rate for Payer: UHCCP DNSP |
$57.24
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
|
