|
PR SKIN LESION SHAVE/EXCISION (30 MIN)
|
Professional
|
Both
|
$525.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: BCBS Complete |
$210.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
|
|
PR SKYLA, 13.5 MG
|
Professional
|
Both
|
$1,506.00
|
|
|
Service Code
|
HCPCS J7301
|
| Min. Negotiated Rate |
$917.35 |
| Max. Negotiated Rate |
$1,129.50 |
| Rate for Payer: Aetna Commercial |
$917.35
|
| Rate for Payer: BCBS Complete |
$1,125.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,019.71
|
| Rate for Payer: BCN Commercial |
$1,020.68
|
| Rate for Payer: Cash Price |
$1,204.80
|
| Rate for Payer: Cash Price |
$1,204.80
|
| Rate for Payer: Meridian Medicaid |
$1,125.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,129.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,072.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,059.52
|
| Rate for Payer: UHC Exchange |
$1,059.52
|
| Rate for Payer: UHC Medicaid |
$1,072.06
|
| Rate for Payer: UHCCP Medicaid |
$1,072.06
|
|
|
PR SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN
|
Professional
|
Both
|
$529.00
|
|
|
Service Code
|
HCPCS 36251
|
| Min. Negotiated Rate |
$143.14 |
| Max. Negotiated Rate |
$463.33 |
| Rate for Payer: Aetna Commercial |
$303.13
|
| Rate for Payer: Aetna Medicare |
$226.22
|
| Rate for Payer: BCBS Complete |
$150.30
|
| Rate for Payer: BCBS MAPPO |
$226.22
|
| Rate for Payer: BCN Commercial |
$371.49
|
| Rate for Payer: BCN Medicare Advantage |
$226.22
|
| Rate for Payer: Cash Price |
$423.20
|
| Rate for Payer: Cash Price |
$423.20
|
| Rate for Payer: Cofinity Commercial |
$303.13
|
| Rate for Payer: Cofinity Commercial |
$325.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.22
|
| Rate for Payer: Healthscope Commercial |
$271.46
|
| Rate for Payer: Healthscope Whirlpool |
$271.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.53
|
| Rate for Payer: Meridian Medicaid |
$150.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.84
|
| Rate for Payer: Nomi Health Commercial |
$271.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.75
|
| Rate for Payer: PACE SWMI |
$226.22
|
| Rate for Payer: PHP Medicare Advantage |
$226.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$399.49
|
| Rate for Payer: Priority Health Medicare |
$226.22
|
| Rate for Payer: Priority Health Narrow Network |
$399.49
|
| Rate for Payer: Railroad Medicare Medicare |
$226.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$463.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.22
|
| Rate for Payer: UHC Exchange |
$463.33
|
| Rate for Payer: UHC Medicaid |
$143.14
|
| Rate for Payer: UHCCP DNSP |
$226.22
|
| Rate for Payer: UHCCP Medicaid |
$143.14
|
|
|
PR SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL
|
Professional
|
Both
|
$689.00
|
|
|
Service Code
|
HCPCS 36252
|
| Min. Negotiated Rate |
$197.45 |
| Max. Negotiated Rate |
$642.76 |
| Rate for Payer: Aetna Commercial |
$418.70
|
| Rate for Payer: Aetna Medicare |
$312.46
|
| Rate for Payer: BCBS Complete |
$207.32
|
| Rate for Payer: BCBS MAPPO |
$312.46
|
| Rate for Payer: BCN Commercial |
$520.39
|
| Rate for Payer: BCN Medicare Advantage |
$312.46
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cofinity Commercial |
$449.94
|
| Rate for Payer: Cofinity Commercial |
$418.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.46
|
| Rate for Payer: Healthscope Commercial |
$374.95
|
| Rate for Payer: Healthscope Whirlpool |
$374.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.08
|
| Rate for Payer: Meridian Medicaid |
$207.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$343.71
|
| Rate for Payer: Nomi Health Commercial |
$374.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.75
|
| Rate for Payer: PACE SWMI |
$312.46
|
| Rate for Payer: PHP Medicare Advantage |
$312.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$559.61
|
| Rate for Payer: Priority Health Medicare |
$312.46
|
| Rate for Payer: Priority Health Narrow Network |
$559.61
|
| Rate for Payer: Railroad Medicare Medicare |
$312.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$642.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.46
|
| Rate for Payer: UHC Exchange |
$642.76
|
| Rate for Payer: UHC Medicaid |
$197.45
|
| Rate for Payer: UHCCP DNSP |
$312.46
|
| Rate for Payer: UHCCP Medicaid |
$197.45
|
|
|
PR SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART
|
Professional
|
Both
|
$1,855.00
|
|
|
Service Code
|
HCPCS 36223
|
| Min. Negotiated Rate |
$189.57 |
| Max. Negotiated Rate |
$1,391.25 |
| Rate for Payer: Aetna Commercial |
$402.05
|
| Rate for Payer: Aetna Medicare |
$300.04
|
| Rate for Payer: BCBS Complete |
$199.05
|
| Rate for Payer: BCBS MAPPO |
$300.04
|
| Rate for Payer: BCN Commercial |
$489.52
|
| Rate for Payer: BCN Medicare Advantage |
$300.04
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cofinity Commercial |
$432.06
|
| Rate for Payer: Cofinity Commercial |
$402.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.04
|
| Rate for Payer: Healthscope Commercial |
$360.05
|
| Rate for Payer: Healthscope Whirlpool |
$360.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.04
|
| Rate for Payer: Meridian Medicaid |
$199.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$330.04
|
| Rate for Payer: Nomi Health Commercial |
$360.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,391.25
|
| Rate for Payer: PACE SWMI |
$300.04
|
| Rate for Payer: PHP Medicare Advantage |
$300.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$526.42
|
| Rate for Payer: Priority Health Medicare |
$300.04
|
| Rate for Payer: Priority Health Narrow Network |
$526.42
|
| Rate for Payer: Railroad Medicare Medicare |
$300.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$565.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$300.04
|
| Rate for Payer: UHC Exchange |
$565.01
|
| Rate for Payer: UHC Medicaid |
$189.57
|
| Rate for Payer: UHCCP DNSP |
$300.04
|
| Rate for Payer: UHCCP Medicaid |
$189.57
|
|
|
PR SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 36222
|
| Min. Negotiated Rate |
$161.03 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$341.65
|
| Rate for Payer: Aetna Medicare |
$254.96
|
| Rate for Payer: BCBS Complete |
$169.08
|
| Rate for Payer: BCBS MAPPO |
$254.96
|
| Rate for Payer: BCN Commercial |
$420.80
|
| Rate for Payer: BCN Medicare Advantage |
$254.96
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cofinity Commercial |
$367.14
|
| Rate for Payer: Cofinity Commercial |
$341.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.96
|
| Rate for Payer: Healthscope Commercial |
$305.95
|
| Rate for Payer: Healthscope Whirlpool |
$305.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.71
|
| Rate for Payer: Meridian Medicaid |
$169.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$280.46
|
| Rate for Payer: Nomi Health Commercial |
$305.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,278.75
|
| Rate for Payer: PACE SWMI |
$254.96
|
| Rate for Payer: PHP Medicare Advantage |
$254.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$452.51
|
| Rate for Payer: Priority Health Medicare |
$254.96
|
| Rate for Payer: Priority Health Narrow Network |
$452.51
|
| Rate for Payer: Railroad Medicare Medicare |
$254.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$254.96
|
| Rate for Payer: UHC Exchange |
$504.88
|
| Rate for Payer: UHC Medicaid |
$161.03
|
| Rate for Payer: UHCCP DNSP |
$254.96
|
| Rate for Payer: UHCCP Medicaid |
$161.03
|
|
|
PR SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY
|
Professional
|
Both
|
$1,039.00
|
|
|
Service Code
|
HCPCS 36014
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$779.25 |
| Rate for Payer: Aetna Commercial |
$175.86
|
| Rate for Payer: Aetna Medicare |
$131.24
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$131.24
|
| Rate for Payer: BCN Commercial |
$222.10
|
| Rate for Payer: BCN Medicare Advantage |
$131.24
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Cofinity Commercial |
$188.99
|
| Rate for Payer: Cofinity Commercial |
$175.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.24
|
| Rate for Payer: Healthscope Commercial |
$157.49
|
| Rate for Payer: Healthscope Whirlpool |
$157.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.80
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$144.36
|
| Rate for Payer: Nomi Health Commercial |
$157.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$779.25
|
| Rate for Payer: PACE SWMI |
$131.24
|
| Rate for Payer: PHP Medicare Advantage |
$131.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$238.85
|
| Rate for Payer: Priority Health Medicare |
$131.24
|
| Rate for Payer: Priority Health Narrow Network |
$238.85
|
| Rate for Payer: Railroad Medicare Medicare |
$131.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$131.24
|
| Rate for Payer: UHC Exchange |
$271.84
|
| Rate for Payer: UHC Medicaid |
$83.28
|
| Rate for Payer: UHCCP DNSP |
$131.24
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
|
|
PR SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT
|
Professional
|
Both
|
$1,401.00
|
|
|
Service Code
|
HCPCS 36228
|
| Min. Negotiated Rate |
$143.35 |
| Max. Negotiated Rate |
$1,050.75 |
| Rate for Payer: Aetna Commercial |
$304.96
|
| Rate for Payer: Aetna Medicare |
$227.58
|
| Rate for Payer: BCBS Complete |
$150.52
|
| Rate for Payer: BCBS MAPPO |
$227.58
|
| Rate for Payer: BCN Commercial |
$372.49
|
| Rate for Payer: BCN Medicare Advantage |
$227.58
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cofinity Commercial |
$327.72
|
| Rate for Payer: Cofinity Commercial |
$304.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.58
|
| Rate for Payer: Healthscope Commercial |
$273.10
|
| Rate for Payer: Healthscope Whirlpool |
$273.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.96
|
| Rate for Payer: Meridian Medicaid |
$150.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$250.34
|
| Rate for Payer: Nomi Health Commercial |
$273.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,050.75
|
| Rate for Payer: PACE SWMI |
$227.58
|
| Rate for Payer: PHP Medicare Advantage |
$227.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$400.56
|
| Rate for Payer: Priority Health Medicare |
$227.58
|
| Rate for Payer: Priority Health Narrow Network |
$400.56
|
| Rate for Payer: Railroad Medicare Medicare |
$227.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$429.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$227.58
|
| Rate for Payer: UHC Exchange |
$429.38
|
| Rate for Payer: UHC Medicaid |
$143.35
|
| Rate for Payer: UHCCP DNSP |
$227.58
|
| Rate for Payer: UHCCP Medicaid |
$143.35
|
|
|
PR SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART
|
Professional
|
Both
|
$1,296.00
|
|
|
Service Code
|
HCPCS 36224
|
| Min. Negotiated Rate |
$211.72 |
| Max. Negotiated Rate |
$972.00 |
| Rate for Payer: Aetna Commercial |
$448.85
|
| Rate for Payer: Aetna Medicare |
$334.96
|
| Rate for Payer: BCBS Complete |
$222.31
|
| Rate for Payer: BCBS MAPPO |
$334.96
|
| Rate for Payer: BCN Commercial |
$549.77
|
| Rate for Payer: BCN Medicare Advantage |
$334.96
|
| Rate for Payer: Cash Price |
$1,036.80
|
| Rate for Payer: Cash Price |
$1,036.80
|
| Rate for Payer: Cofinity Commercial |
$482.34
|
| Rate for Payer: Cofinity Commercial |
$448.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.96
|
| Rate for Payer: Healthscope Commercial |
$401.95
|
| Rate for Payer: Healthscope Whirlpool |
$401.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$351.71
|
| Rate for Payer: Meridian Medicaid |
$222.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$368.46
|
| Rate for Payer: Nomi Health Commercial |
$401.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.00
|
| Rate for Payer: PACE SWMI |
$334.96
|
| Rate for Payer: PHP Medicare Advantage |
$334.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$591.22
|
| Rate for Payer: Priority Health Medicare |
$334.96
|
| Rate for Payer: Priority Health Narrow Network |
$591.22
|
| Rate for Payer: Railroad Medicare Medicare |
$334.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$640.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$334.96
|
| Rate for Payer: UHC Exchange |
$640.93
|
| Rate for Payer: UHC Medicaid |
$211.72
|
| Rate for Payer: UHCCP DNSP |
$334.96
|
| Rate for Payer: UHCCP Medicaid |
$211.72
|
|
|
PR SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$2,414.00
|
|
|
Service Code
|
HCPCS 36216
|
| Min. Negotiated Rate |
$155.28 |
| Max. Negotiated Rate |
$1,810.50 |
| Rate for Payer: Aetna Commercial |
$328.84
|
| Rate for Payer: Aetna Medicare |
$245.40
|
| Rate for Payer: BCBS Complete |
$163.04
|
| Rate for Payer: BCBS MAPPO |
$245.40
|
| Rate for Payer: BCN Commercial |
$399.39
|
| Rate for Payer: BCN Medicare Advantage |
$245.40
|
| Rate for Payer: Cash Price |
$1,931.20
|
| Rate for Payer: Cash Price |
$1,931.20
|
| Rate for Payer: Cofinity Commercial |
$353.38
|
| Rate for Payer: Cofinity Commercial |
$328.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.40
|
| Rate for Payer: Healthscope Commercial |
$294.48
|
| Rate for Payer: Healthscope Whirlpool |
$294.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$257.67
|
| Rate for Payer: Meridian Medicaid |
$163.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$269.94
|
| Rate for Payer: Nomi Health Commercial |
$294.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,810.50
|
| Rate for Payer: PACE SWMI |
$245.40
|
| Rate for Payer: PHP Medicare Advantage |
$245.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$429.49
|
| Rate for Payer: Priority Health Medicare |
$245.40
|
| Rate for Payer: Priority Health Narrow Network |
$429.49
|
| Rate for Payer: Railroad Medicare Medicare |
$245.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.40
|
| Rate for Payer: UHC Exchange |
$487.06
|
| Rate for Payer: UHC Medicaid |
$155.28
|
| Rate for Payer: UHCCP DNSP |
$245.40
|
| Rate for Payer: UHCCP Medicaid |
$155.28
|
|
|
PR SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$1,073.00
|
|
|
Service Code
|
HCPCS 36246
|
| Min. Negotiated Rate |
$141.22 |
| Max. Negotiated Rate |
$804.75 |
| Rate for Payer: Aetna Commercial |
$300.12
|
| Rate for Payer: Aetna Medicare |
$223.97
|
| Rate for Payer: BCBS Complete |
$148.28
|
| Rate for Payer: BCBS MAPPO |
$223.97
|
| Rate for Payer: BCN Commercial |
$367.51
|
| Rate for Payer: BCN Medicare Advantage |
$223.97
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cofinity Commercial |
$322.52
|
| Rate for Payer: Cofinity Commercial |
$300.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.97
|
| Rate for Payer: Healthscope Commercial |
$268.76
|
| Rate for Payer: Healthscope Whirlpool |
$268.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.17
|
| Rate for Payer: Meridian Medicaid |
$148.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$246.37
|
| Rate for Payer: Nomi Health Commercial |
$268.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.75
|
| Rate for Payer: PACE SWMI |
$223.97
|
| Rate for Payer: PHP Medicare Advantage |
$223.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$395.22
|
| Rate for Payer: Priority Health Medicare |
$223.97
|
| Rate for Payer: Priority Health Narrow Network |
$395.22
|
| Rate for Payer: Railroad Medicare Medicare |
$223.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$454.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$223.97
|
| Rate for Payer: UHC Exchange |
$454.17
|
| Rate for Payer: UHC Medicaid |
$141.22
|
| Rate for Payer: UHCCP DNSP |
$223.97
|
| Rate for Payer: UHCCP Medicaid |
$141.22
|
|
|
PR SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 36247
|
| Min. Negotiated Rate |
$165.08 |
| Max. Negotiated Rate |
$1,007.25 |
| Rate for Payer: Aetna Commercial |
$349.19
|
| Rate for Payer: Aetna Medicare |
$260.59
|
| Rate for Payer: BCBS Complete |
$173.33
|
| Rate for Payer: BCBS MAPPO |
$260.59
|
| Rate for Payer: BCN Commercial |
$433.74
|
| Rate for Payer: BCN Medicare Advantage |
$260.59
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$375.25
|
| Rate for Payer: Cofinity Commercial |
$349.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.59
|
| Rate for Payer: Healthscope Commercial |
$312.71
|
| Rate for Payer: Healthscope Whirlpool |
$312.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.62
|
| Rate for Payer: Meridian Medicaid |
$173.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$286.65
|
| Rate for Payer: Nomi Health Commercial |
$312.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,007.25
|
| Rate for Payer: PACE SWMI |
$260.59
|
| Rate for Payer: PHP Medicare Advantage |
$260.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$466.44
|
| Rate for Payer: Priority Health Medicare |
$260.59
|
| Rate for Payer: Priority Health Narrow Network |
$466.44
|
| Rate for Payer: Railroad Medicare Medicare |
$260.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$540.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$260.59
|
| Rate for Payer: UHC Exchange |
$540.37
|
| Rate for Payer: UHC Medicaid |
$165.08
|
| Rate for Payer: UHCCP DNSP |
$260.59
|
| Rate for Payer: UHCCP Medicaid |
$165.08
|
|
|
PR SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 36217
|
| Min. Negotiated Rate |
$192.34 |
| Max. Negotiated Rate |
$1,063.50 |
| Rate for Payer: Aetna Commercial |
$407.65
|
| Rate for Payer: Aetna Medicare |
$304.22
|
| Rate for Payer: BCBS Complete |
$201.96
|
| Rate for Payer: BCBS MAPPO |
$304.22
|
| Rate for Payer: BCN Commercial |
$496.49
|
| Rate for Payer: BCN Medicare Advantage |
$304.22
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$438.08
|
| Rate for Payer: Cofinity Commercial |
$407.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.22
|
| Rate for Payer: Healthscope Commercial |
$365.06
|
| Rate for Payer: Healthscope Whirlpool |
$365.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.43
|
| Rate for Payer: Meridian Medicaid |
$201.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$334.64
|
| Rate for Payer: Nomi Health Commercial |
$365.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,063.50
|
| Rate for Payer: PACE SWMI |
$304.22
|
| Rate for Payer: PHP Medicare Advantage |
$304.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$533.90
|
| Rate for Payer: Priority Health Medicare |
$304.22
|
| Rate for Payer: Priority Health Narrow Network |
$533.90
|
| Rate for Payer: Railroad Medicare Medicare |
$304.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$586.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$304.22
|
| Rate for Payer: UHC Exchange |
$586.95
|
| Rate for Payer: UHC Medicaid |
$192.34
|
| Rate for Payer: UHCCP DNSP |
$304.22
|
| Rate for Payer: UHCCP Medicaid |
$192.34
|
|
|
PR SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
HCPCS 36245
|
| Min. Negotiated Rate |
$132.06 |
| Max. Negotiated Rate |
$645.00 |
| Rate for Payer: Aetna Commercial |
$279.31
|
| Rate for Payer: Aetna Medicare |
$208.44
|
| Rate for Payer: BCBS Complete |
$138.66
|
| Rate for Payer: BCBS MAPPO |
$208.44
|
| Rate for Payer: BCN Commercial |
$345.10
|
| Rate for Payer: BCN Medicare Advantage |
$208.44
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cofinity Commercial |
$300.15
|
| Rate for Payer: Cofinity Commercial |
$279.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.44
|
| Rate for Payer: Healthscope Commercial |
$250.13
|
| Rate for Payer: Healthscope Whirlpool |
$250.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.86
|
| Rate for Payer: Meridian Medicaid |
$138.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.28
|
| Rate for Payer: Nomi Health Commercial |
$250.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$645.00
|
| Rate for Payer: PACE SWMI |
$208.44
|
| Rate for Payer: PHP Medicare Advantage |
$208.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$371.11
|
| Rate for Payer: Priority Health Medicare |
$208.44
|
| Rate for Payer: Priority Health Narrow Network |
$371.11
|
| Rate for Payer: Railroad Medicare Medicare |
$208.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$424.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$208.44
|
| Rate for Payer: UHC Exchange |
$424.82
|
| Rate for Payer: UHC Medicaid |
$132.06
|
| Rate for Payer: UHCCP DNSP |
$208.44
|
| Rate for Payer: UHCCP Medicaid |
$132.06
|
|
|
PR SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 36215
|
| Min. Negotiated Rate |
$119.92 |
| Max. Negotiated Rate |
$709.50 |
| Rate for Payer: Aetna Commercial |
$251.91
|
| Rate for Payer: Aetna Medicare |
$187.99
|
| Rate for Payer: BCBS Complete |
$125.92
|
| Rate for Payer: BCBS MAPPO |
$187.99
|
| Rate for Payer: BCN Commercial |
$312.73
|
| Rate for Payer: BCN Medicare Advantage |
$187.99
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cofinity Commercial |
$270.71
|
| Rate for Payer: Cofinity Commercial |
$251.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.99
|
| Rate for Payer: Healthscope Commercial |
$225.59
|
| Rate for Payer: Healthscope Whirlpool |
$225.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.39
|
| Rate for Payer: Meridian Medicaid |
$125.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$206.79
|
| Rate for Payer: Nomi Health Commercial |
$225.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: PACE SWMI |
$187.99
|
| Rate for Payer: PHP Medicare Advantage |
$187.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$336.31
|
| Rate for Payer: Priority Health Medicare |
$187.99
|
| Rate for Payer: Priority Health Narrow Network |
$336.31
|
| Rate for Payer: Railroad Medicare Medicare |
$187.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$377.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$187.99
|
| Rate for Payer: UHC Exchange |
$377.32
|
| Rate for Payer: UHC Medicaid |
$119.92
|
| Rate for Payer: UHCCP DNSP |
$187.99
|
| Rate for Payer: UHCCP Medicaid |
$119.92
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 36248
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$55.65
|
| Rate for Payer: Aetna Medicare |
$41.53
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$41.53
|
| Rate for Payer: BCN Commercial |
$70.71
|
| Rate for Payer: BCN Medicare Advantage |
$41.53
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cofinity Commercial |
$59.80
|
| Rate for Payer: Cofinity Commercial |
$55.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.53
|
| Rate for Payer: Healthscope Commercial |
$49.84
|
| Rate for Payer: Healthscope Whirlpool |
$49.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.61
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.68
|
| Rate for Payer: Nomi Health Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: PACE SWMI |
$41.53
|
| Rate for Payer: PHP Medicare Advantage |
$41.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$76.04
|
| Rate for Payer: Priority Health Medicare |
$41.53
|
| Rate for Payer: Priority Health Narrow Network |
$76.04
|
| Rate for Payer: Railroad Medicare Medicare |
$41.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.53
|
| Rate for Payer: UHC Exchange |
$86.98
|
| Rate for Payer: UHC Medicaid |
$26.41
|
| Rate for Payer: UHCCP DNSP |
$41.53
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 36218
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$62.65
|
| Rate for Payer: Aetna Medicare |
$46.75
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS MAPPO |
$46.75
|
| Rate for Payer: BCN Commercial |
$77.18
|
| Rate for Payer: BCN Medicare Advantage |
$46.75
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$67.32
|
| Rate for Payer: Cofinity Commercial |
$62.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.75
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$56.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.09
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.42
|
| Rate for Payer: Nomi Health Commercial |
$56.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$46.75
|
| Rate for Payer: PHP Medicare Advantage |
$46.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$83.01
|
| Rate for Payer: Priority Health Medicare |
$46.75
|
| Rate for Payer: Priority Health Narrow Network |
$83.01
|
| Rate for Payer: Railroad Medicare Medicare |
$46.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.75
|
| Rate for Payer: UHC Exchange |
$92.53
|
| Rate for Payer: UHC Medicaid |
$29.61
|
| Rate for Payer: UHCCP DNSP |
$46.75
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
|
|
PR SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART
|
Professional
|
Both
|
$985.00
|
|
|
Service Code
|
HCPCS 36015
|
| Min. Negotiated Rate |
$95.00 |
| Max. Negotiated Rate |
$738.75 |
| Rate for Payer: Aetna Commercial |
$200.30
|
| Rate for Payer: Aetna Medicare |
$149.48
|
| Rate for Payer: BCBS Complete |
$99.75
|
| Rate for Payer: BCBS MAPPO |
$149.48
|
| Rate for Payer: BCN Commercial |
$252.48
|
| Rate for Payer: BCN Medicare Advantage |
$149.48
|
| Rate for Payer: Cash Price |
$788.00
|
| Rate for Payer: Cash Price |
$788.00
|
| Rate for Payer: Cofinity Commercial |
$215.25
|
| Rate for Payer: Cofinity Commercial |
$200.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.48
|
| Rate for Payer: Healthscope Commercial |
$179.38
|
| Rate for Payer: Healthscope Whirlpool |
$179.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.95
|
| Rate for Payer: Meridian Medicaid |
$99.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$164.43
|
| Rate for Payer: Nomi Health Commercial |
$179.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$738.75
|
| Rate for Payer: PACE SWMI |
$149.48
|
| Rate for Payer: PHP Medicare Advantage |
$149.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$271.51
|
| Rate for Payer: Priority Health Medicare |
$149.48
|
| Rate for Payer: Priority Health Narrow Network |
$271.51
|
| Rate for Payer: Railroad Medicare Medicare |
$149.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$149.48
|
| Rate for Payer: UHC Exchange |
$308.14
|
| Rate for Payer: UHC Medicaid |
$95.00
|
| Rate for Payer: UHCCP DNSP |
$149.48
|
| Rate for Payer: UHCCP Medicaid |
$95.00
|
|
|
PR SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH
|
Professional
|
Both
|
$769.00
|
|
|
Service Code
|
HCPCS 36011
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$576.75 |
| Rate for Payer: Aetna Commercial |
$184.26
|
| Rate for Payer: Aetna Medicare |
$137.51
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$137.51
|
| Rate for Payer: BCN Commercial |
$228.07
|
| Rate for Payer: BCN Medicare Advantage |
$137.51
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cofinity Commercial |
$198.01
|
| Rate for Payer: Cofinity Commercial |
$184.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.51
|
| Rate for Payer: Healthscope Commercial |
$165.01
|
| Rate for Payer: Healthscope Whirlpool |
$165.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.39
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.26
|
| Rate for Payer: Nomi Health Commercial |
$165.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$576.75
|
| Rate for Payer: PACE SWMI |
$137.51
|
| Rate for Payer: PHP Medicare Advantage |
$137.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$245.27
|
| Rate for Payer: Priority Health Medicare |
$137.51
|
| Rate for Payer: Priority Health Narrow Network |
$245.27
|
| Rate for Payer: Railroad Medicare Medicare |
$137.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$281.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$137.51
|
| Rate for Payer: UHC Exchange |
$281.88
|
| Rate for Payer: UHC Medicaid |
$87.12
|
| Rate for Payer: UHCCP DNSP |
$137.51
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
|
|
PR SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC
|
Professional
|
Both
|
$1,009.00
|
|
|
Service Code
|
HCPCS 36012
|
| Min. Negotiated Rate |
$97.98 |
| Max. Negotiated Rate |
$756.75 |
| Rate for Payer: Aetna Commercial |
$207.28
|
| Rate for Payer: Aetna Medicare |
$154.69
|
| Rate for Payer: BCBS Complete |
$102.88
|
| Rate for Payer: BCBS MAPPO |
$154.69
|
| Rate for Payer: BCN Commercial |
$255.97
|
| Rate for Payer: BCN Medicare Advantage |
$154.69
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Cofinity Commercial |
$222.75
|
| Rate for Payer: Cofinity Commercial |
$207.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.69
|
| Rate for Payer: Healthscope Commercial |
$185.63
|
| Rate for Payer: Healthscope Whirlpool |
$185.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.42
|
| Rate for Payer: Meridian Medicaid |
$102.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$170.16
|
| Rate for Payer: Nomi Health Commercial |
$185.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$756.75
|
| Rate for Payer: PACE SWMI |
$154.69
|
| Rate for Payer: PHP Medicare Advantage |
$154.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$275.25
|
| Rate for Payer: Priority Health Medicare |
$154.69
|
| Rate for Payer: Priority Health Narrow Network |
$275.25
|
| Rate for Payer: Railroad Medicare Medicare |
$154.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$311.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$154.69
|
| Rate for Payer: UHC Exchange |
$311.18
|
| Rate for Payer: UHC Medicaid |
$97.98
|
| Rate for Payer: UHCCP DNSP |
$154.69
|
| Rate for Payer: UHCCP Medicaid |
$97.98
|
|
|
PR SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,842.00
|
|
|
Service Code
|
HCPCS 36225
|
| Min. Negotiated Rate |
$187.65 |
| Max. Negotiated Rate |
$1,381.50 |
| Rate for Payer: Aetna Commercial |
$398.19
|
| Rate for Payer: Aetna Medicare |
$297.16
|
| Rate for Payer: BCBS Complete |
$197.03
|
| Rate for Payer: BCBS MAPPO |
$297.16
|
| Rate for Payer: BCN Commercial |
$486.53
|
| Rate for Payer: BCN Medicare Advantage |
$297.16
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cofinity Commercial |
$427.91
|
| Rate for Payer: Cofinity Commercial |
$398.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.16
|
| Rate for Payer: Healthscope Commercial |
$356.59
|
| Rate for Payer: Healthscope Whirlpool |
$356.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.02
|
| Rate for Payer: Meridian Medicaid |
$197.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.88
|
| Rate for Payer: Nomi Health Commercial |
$356.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,381.50
|
| Rate for Payer: PACE SWMI |
$297.16
|
| Rate for Payer: PHP Medicare Advantage |
$297.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$523.21
|
| Rate for Payer: Priority Health Medicare |
$297.16
|
| Rate for Payer: Priority Health Narrow Network |
$523.21
|
| Rate for Payer: Railroad Medicare Medicare |
$297.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$563.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.16
|
| Rate for Payer: UHC Exchange |
$563.45
|
| Rate for Payer: UHC Medicaid |
$187.65
|
| Rate for Payer: UHCCP DNSP |
$297.16
|
| Rate for Payer: UHCCP Medicaid |
$187.65
|
|
|
PR SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,298.00
|
|
|
Service Code
|
HCPCS 36226
|
| Min. Negotiated Rate |
$210.02 |
| Max. Negotiated Rate |
$973.50 |
| Rate for Payer: Aetna Commercial |
$445.19
|
| Rate for Payer: Aetna Medicare |
$332.23
|
| Rate for Payer: BCBS Complete |
$220.52
|
| Rate for Payer: BCBS MAPPO |
$332.23
|
| Rate for Payer: BCN Commercial |
$545.79
|
| Rate for Payer: BCN Medicare Advantage |
$332.23
|
| Rate for Payer: Cash Price |
$1,038.40
|
| Rate for Payer: Cash Price |
$1,038.40
|
| Rate for Payer: Cofinity Commercial |
$478.41
|
| Rate for Payer: Cofinity Commercial |
$445.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.23
|
| Rate for Payer: Healthscope Commercial |
$398.68
|
| Rate for Payer: Healthscope Whirlpool |
$398.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.84
|
| Rate for Payer: Meridian Medicaid |
$220.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.45
|
| Rate for Payer: Nomi Health Commercial |
$398.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$973.50
|
| Rate for Payer: PACE SWMI |
$332.23
|
| Rate for Payer: PHP Medicare Advantage |
$332.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$586.93
|
| Rate for Payer: Priority Health Medicare |
$332.23
|
| Rate for Payer: Priority Health Narrow Network |
$586.93
|
| Rate for Payer: Railroad Medicare Medicare |
$332.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$631.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$332.23
|
| Rate for Payer: UHC Exchange |
$631.95
|
| Rate for Payer: UHC Medicaid |
$210.02
|
| Rate for Payer: UHCCP DNSP |
$332.23
|
| Rate for Payer: UHCCP Medicaid |
$210.02
|
|
|
PR SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 36227
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: Aetna Medicare |
$109.42
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$109.42
|
| Rate for Payer: BCN Commercial |
$179.77
|
| Rate for Payer: BCN Medicare Advantage |
$109.42
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$157.56
|
| Rate for Payer: Cofinity Commercial |
$146.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.42
|
| Rate for Payer: Healthscope Commercial |
$131.30
|
| Rate for Payer: Healthscope Whirlpool |
$131.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.89
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.36
|
| Rate for Payer: Nomi Health Commercial |
$131.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.50
|
| Rate for Payer: PACE SWMI |
$109.42
|
| Rate for Payer: PHP Medicare Advantage |
$109.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$193.32
|
| Rate for Payer: Priority Health Medicare |
$109.42
|
| Rate for Payer: Priority Health Narrow Network |
$193.32
|
| Rate for Payer: Railroad Medicare Medicare |
$109.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.42
|
| Rate for Payer: UHC Exchange |
$209.77
|
| Rate for Payer: UHC Medicaid |
$69.01
|
| Rate for Payer: UHCCP DNSP |
$109.42
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
|
|
PR SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 95806
|
| Min. Negotiated Rate |
$97.31 |
| Max. Negotiated Rate |
$180.24 |
| Rate for Payer: Aetna Commercial |
$130.40
|
| Rate for Payer: Aetna Commercial |
$130.40
|
| Rate for Payer: Aetna Medicare |
$97.31
|
| Rate for Payer: Aetna Medicare |
$97.31
|
| Rate for Payer: BCBS MAPPO |
$97.31
|
| Rate for Payer: BCBS MAPPO |
$97.31
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Medicare Advantage |
$97.31
|
| Rate for Payer: BCN Medicare Advantage |
$97.31
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Cofinity Commercial |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$140.13
|
| Rate for Payer: Cofinity Commercial |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$140.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.31
|
| Rate for Payer: Healthscope Commercial |
$116.77
|
| Rate for Payer: Healthscope Commercial |
$116.77
|
| Rate for Payer: Healthscope Whirlpool |
$116.77
|
| Rate for Payer: Healthscope Whirlpool |
$116.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.04
|
| Rate for Payer: Nomi Health Commercial |
$116.77
|
| Rate for Payer: Nomi Health Commercial |
$116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.75
|
| Rate for Payer: PACE SWMI |
$97.31
|
| Rate for Payer: PACE SWMI |
$97.31
|
| Rate for Payer: PHP Medicare Advantage |
$97.31
|
| Rate for Payer: PHP Medicare Advantage |
$97.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$132.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$132.27
|
| Rate for Payer: Priority Health Medicare |
$97.31
|
| Rate for Payer: Priority Health Medicare |
$97.31
|
| Rate for Payer: Priority Health Narrow Network |
$132.27
|
| Rate for Payer: Priority Health Narrow Network |
$132.27
|
| Rate for Payer: Railroad Medicare Medicare |
$97.31
|
| Rate for Payer: Railroad Medicare Medicare |
$97.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.31
|
| Rate for Payer: UHC Exchange |
$180.24
|
| Rate for Payer: UHC Exchange |
$180.24
|
| Rate for Payer: UHCCP DNSP |
$97.31
|
| Rate for Payer: UHCCP DNSP |
$97.31
|
|
|
PR SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
HCPCS 95807
|
| Min. Negotiated Rate |
$114.00 |
| Max. Negotiated Rate |
$617.87 |
| Rate for Payer: Aetna Commercial |
$549.17
|
| Rate for Payer: Aetna Commercial |
$549.17
|
| Rate for Payer: Aetna Medicare |
$409.83
|
| Rate for Payer: Aetna Medicare |
$409.83
|
| Rate for Payer: BCBS MAPPO |
$409.83
|
| Rate for Payer: BCBS MAPPO |
$409.83
|
| Rate for Payer: BCN Commercial |
$487.73
|
| Rate for Payer: BCN Commercial |
$487.73
|
| Rate for Payer: BCN Medicare Advantage |
$409.83
|
| Rate for Payer: BCN Medicare Advantage |
$409.83
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$1,227.20
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$1,227.20
|
| Rate for Payer: Cofinity Commercial |
$549.17
|
| Rate for Payer: Cofinity Commercial |
$590.16
|
| Rate for Payer: Cofinity Commercial |
$549.17
|
| Rate for Payer: Cofinity Commercial |
$590.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.83
|
| Rate for Payer: Healthscope Commercial |
$491.80
|
| Rate for Payer: Healthscope Commercial |
$491.80
|
| Rate for Payer: Healthscope Whirlpool |
$491.80
|
| Rate for Payer: Healthscope Whirlpool |
$491.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$450.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$450.81
|
| Rate for Payer: Nomi Health Commercial |
$491.80
|
| Rate for Payer: Nomi Health Commercial |
$491.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,150.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.00
|
| Rate for Payer: PACE SWMI |
$409.83
|
| Rate for Payer: PACE SWMI |
$409.83
|
| Rate for Payer: PHP Medicare Advantage |
$409.83
|
| Rate for Payer: PHP Medicare Advantage |
$409.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$570.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$570.38
|
| Rate for Payer: Priority Health Medicare |
$409.83
|
| Rate for Payer: Priority Health Medicare |
$409.83
|
| Rate for Payer: Priority Health Narrow Network |
$570.38
|
| Rate for Payer: Priority Health Narrow Network |
$570.38
|
| Rate for Payer: Railroad Medicare Medicare |
$409.83
|
| Rate for Payer: Railroad Medicare Medicare |
$409.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$617.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$617.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$409.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$409.83
|
| Rate for Payer: UHC Exchange |
$617.87
|
| Rate for Payer: UHC Exchange |
$617.87
|
| Rate for Payer: UHCCP DNSP |
$409.83
|
| Rate for Payer: UHCCP DNSP |
$409.83
|
|
