|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 45335
|
| Min. Negotiated Rate |
$63.87 |
| Max. Negotiated Rate |
$422.50 |
| Rate for Payer: Aetna Commercial |
$85.59
|
| Rate for Payer: Aetna Medicare |
$63.87
|
| Rate for Payer: BCBS Complete |
$260.00
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| Rate for Payer: Cofinity Commercial |
$85.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Healthscope Commercial |
$76.64
|
| Rate for Payer: Healthscope Whirlpool |
$76.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Nomi Health Commercial |
$76.64
|
| Rate for Payer: PACE SWMI |
$63.87
|
| Rate for Payer: PHP Medicare Advantage |
$63.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
| Rate for Payer: UHCCP DNSP |
$63.87
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$422.50 |
| Max. Negotiated Rate |
$1,378.21 |
| Rate for Payer: Aetna Commercial |
$585.00
|
| Rate for Payer: Aetna Medicare |
$889.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: ASR ASR |
$630.50
|
| Rate for Payer: ASR Commercial |
$630.50
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCBS Trust/PPO |
$532.28
|
| Rate for Payer: BCN Commercial |
$503.94
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$611.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$650.00
|
| Rate for Payer: Healthscope Whirlpool |
$630.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$889.17
|
| Rate for Payer: Mclaren Commercial |
$585.00
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.50
|
| Rate for Payer: Nomi Health Commercial |
$533.00
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$978.09
|
| Rate for Payer: PHP Medicaid |
$476.60
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$569.53
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health Narrow Network |
$455.65
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$572.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Exchange |
$1,378.21
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP DNSP |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$476.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$422.50 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: Aetna Commercial |
$585.00
|
| Rate for Payer: ASR ASR |
$630.50
|
| Rate for Payer: ASR Commercial |
$630.50
|
| Rate for Payer: BCBS Trust/PPO |
$529.68
|
| Rate for Payer: BCN Commercial |
$503.94
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$611.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Healthscope Commercial |
$650.00
|
| Rate for Payer: Healthscope Whirlpool |
$630.50
|
| Rate for Payer: Mclaren Commercial |
$585.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.50
|
| Rate for Payer: Nomi Health Commercial |
$533.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$572.00
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$63.87 |
| Max. Negotiated Rate |
$422.50 |
| Rate for Payer: Aetna Commercial |
$85.59
|
| Rate for Payer: Aetna Medicare |
$63.87
|
| Rate for Payer: BCBS Complete |
$260.00
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| Rate for Payer: Cofinity Commercial |
$85.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Healthscope Commercial |
$76.64
|
| Rate for Payer: Healthscope Whirlpool |
$76.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Nomi Health Commercial |
$76.64
|
| Rate for Payer: PACE SWMI |
$63.87
|
| Rate for Payer: PHP Medicare Advantage |
$63.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
| Rate for Payer: UHCCP DNSP |
$63.87
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
OP
|
$751.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$488.15 |
| Max. Negotiated Rate |
$1,782.39 |
| Rate for Payer: Aetna Commercial |
$675.90
|
| Rate for Payer: Aetna Medicare |
$1,149.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,437.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,437.41
|
| Rate for Payer: ASR ASR |
$728.47
|
| Rate for Payer: ASR Commercial |
$728.47
|
| Rate for Payer: BCBS Complete |
$647.18
|
| Rate for Payer: BCBS MAPPO |
$1,149.93
|
| Rate for Payer: BCBS Trust/PPO |
$614.99
|
| Rate for Payer: BCN Commercial |
$582.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.93
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$705.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$751.00
|
| Rate for Payer: Healthscope Whirlpool |
$728.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,149.93
|
| Rate for Payer: Mclaren Commercial |
$675.90
|
| Rate for Payer: Mclaren Medicaid |
$616.36
|
| Rate for Payer: Mclaren Medicare |
$1,149.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,207.43
|
| Rate for Payer: Meridian Medicaid |
$647.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,322.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: Nomi Health Commercial |
$615.82
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$1,264.92
|
| Rate for Payer: PHP Medicaid |
$616.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$658.03
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health Narrow Network |
$526.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,149.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$660.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.93
|
| Rate for Payer: UHC Exchange |
$1,782.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.93
|
| Rate for Payer: UHCCP DNSP |
$1,149.93
|
| Rate for Payer: UHCCP Medicaid |
$616.36
|
| Rate for Payer: VA VA |
$1,149.93
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
IP
|
$751.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$488.15 |
| Max. Negotiated Rate |
$751.00 |
| Rate for Payer: Aetna Commercial |
$675.90
|
| Rate for Payer: ASR ASR |
$728.47
|
| Rate for Payer: ASR Commercial |
$728.47
|
| Rate for Payer: BCBS Trust/PPO |
$611.99
|
| Rate for Payer: BCN Commercial |
$582.25
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$705.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Healthscope Commercial |
$751.00
|
| Rate for Payer: Healthscope Whirlpool |
$728.47
|
| Rate for Payer: Mclaren Commercial |
$675.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: Nomi Health Commercial |
$615.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$660.88
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$113.68 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$152.33
|
| Rate for Payer: Aetna Medicare |
$113.68
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: BCBS MAPPO |
$113.68
|
| Rate for Payer: BCN Medicare Advantage |
$113.68
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Commercial |
$152.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.68
|
| Rate for Payer: Healthscope Commercial |
$136.42
|
| Rate for Payer: Healthscope Whirlpool |
$136.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.36
|
| Rate for Payer: Nomi Health Commercial |
$136.42
|
| Rate for Payer: PACE SWMI |
$113.68
|
| Rate for Payer: PHP Medicare Advantage |
$113.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health Medicare |
$113.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.68
|
| Rate for Payer: UHC Medicare Advantage |
$113.68
|
| Rate for Payer: UHCCP DNSP |
$113.68
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45338
|
| Min. Negotiated Rate |
$113.68 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$152.33
|
| Rate for Payer: Aetna Medicare |
$113.68
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: BCBS MAPPO |
$113.68
|
| Rate for Payer: BCN Medicare Advantage |
$113.68
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Commercial |
$152.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.68
|
| Rate for Payer: Healthscope Commercial |
$136.42
|
| Rate for Payer: Healthscope Whirlpool |
$136.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.36
|
| Rate for Payer: Nomi Health Commercial |
$136.42
|
| Rate for Payer: PACE SWMI |
$113.68
|
| Rate for Payer: PHP Medicare Advantage |
$113.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health Medicare |
$113.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.68
|
| Rate for Payer: UHC Medicare Advantage |
$113.68
|
| Rate for Payer: UHCCP DNSP |
$113.68
|
|
|
PR SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE
|
Professional
|
Both
|
$606.00
|
|
|
Service Code
|
HCPCS 45337
|
| Min. Negotiated Rate |
$108.23 |
| Max. Negotiated Rate |
$393.90 |
| Rate for Payer: Aetna Commercial |
$145.03
|
| Rate for Payer: Aetna Medicare |
$108.23
|
| Rate for Payer: BCBS Complete |
$242.40
|
| Rate for Payer: BCBS MAPPO |
$108.23
|
| Rate for Payer: BCN Medicare Advantage |
$108.23
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cofinity Commercial |
$155.85
|
| Rate for Payer: Cofinity Commercial |
$145.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.23
|
| Rate for Payer: Healthscope Commercial |
$129.88
|
| Rate for Payer: Healthscope Whirlpool |
$129.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.64
|
| Rate for Payer: Nomi Health Commercial |
$129.88
|
| Rate for Payer: PACE SWMI |
$108.23
|
| Rate for Payer: PHP Medicare Advantage |
$108.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.90
|
| Rate for Payer: Priority Health Medicare |
$108.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.23
|
| Rate for Payer: UHC Medicare Advantage |
$108.23
|
| Rate for Payer: UHCCP DNSP |
$108.23
|
|
|
PR SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 45349
|
| Min. Negotiated Rate |
$146.00 |
| Max. Negotiated Rate |
$268.37 |
| Rate for Payer: Aetna Commercial |
$249.74
|
| Rate for Payer: Aetna Medicare |
$186.37
|
| Rate for Payer: BCBS Complete |
$146.00
|
| Rate for Payer: BCBS MAPPO |
$186.37
|
| Rate for Payer: BCN Medicare Advantage |
$186.37
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$268.37
|
| Rate for Payer: Cofinity Commercial |
$249.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.37
|
| Rate for Payer: Healthscope Commercial |
$223.64
|
| Rate for Payer: Healthscope Whirlpool |
$223.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.69
|
| Rate for Payer: Nomi Health Commercial |
$223.64
|
| Rate for Payer: PACE SWMI |
$186.37
|
| Rate for Payer: PHP Medicare Advantage |
$186.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.25
|
| Rate for Payer: Priority Health Medicare |
$186.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.37
|
| Rate for Payer: UHC Medicare Advantage |
$186.37
|
| Rate for Payer: UHCCP DNSP |
$186.37
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 11310
|
| Min. Negotiated Rate |
$42.76 |
| Max. Negotiated Rate |
$122.20 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$42.76
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: BCBS MAPPO |
$42.76
|
| Rate for Payer: BCN Medicare Advantage |
$42.76
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$61.57
|
| Rate for Payer: Cofinity Commercial |
$57.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.76
|
| Rate for Payer: Healthscope Commercial |
$51.31
|
| Rate for Payer: Healthscope Whirlpool |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.90
|
| Rate for Payer: Nomi Health Commercial |
$51.31
|
| Rate for Payer: PACE SWMI |
$42.76
|
| Rate for Payer: PHP Medicare Advantage |
$42.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health Medicare |
$42.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.76
|
| Rate for Payer: UHC Medicare Advantage |
$42.76
|
| Rate for Payer: UHCCP DNSP |
$42.76
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
HCPCS 11313
|
| Min. Negotiated Rate |
$90.64 |
| Max. Negotiated Rate |
$199.55 |
| Rate for Payer: Aetna Commercial |
$121.46
|
| Rate for Payer: Aetna Medicare |
$90.64
|
| Rate for Payer: BCBS Complete |
$122.80
|
| Rate for Payer: BCBS MAPPO |
$90.64
|
| Rate for Payer: BCN Medicare Advantage |
$90.64
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cofinity Commercial |
$130.52
|
| Rate for Payer: Cofinity Commercial |
$121.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.64
|
| Rate for Payer: Healthscope Commercial |
$108.77
|
| Rate for Payer: Healthscope Whirlpool |
$108.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.17
|
| Rate for Payer: Nomi Health Commercial |
$108.77
|
| Rate for Payer: PACE SWMI |
$90.64
|
| Rate for Payer: PHP Medicare Advantage |
$90.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.55
|
| Rate for Payer: Priority Health Medicare |
$90.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.64
|
| Rate for Payer: UHC Medicare Advantage |
$90.64
|
| Rate for Payer: UHCCP DNSP |
$90.64
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 11305
|
| Min. Negotiated Rate |
$35.52 |
| Max. Negotiated Rate |
$104.65 |
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Medicare |
$35.52
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$35.52
|
| Rate for Payer: BCN Medicare Advantage |
$35.52
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$47.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.52
|
| Rate for Payer: Healthscope Commercial |
$42.62
|
| Rate for Payer: Healthscope Whirlpool |
$42.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.30
|
| Rate for Payer: Nomi Health Commercial |
$42.62
|
| Rate for Payer: PACE SWMI |
$35.52
|
| Rate for Payer: PHP Medicare Advantage |
$35.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Medicare |
$35.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.52
|
| Rate for Payer: UHC Medicare Advantage |
$35.52
|
| Rate for Payer: UHCCP DNSP |
$35.52
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 11306
|
| Min. Negotiated Rate |
$46.17 |
| Max. Negotiated Rate |
$130.00 |
| Rate for Payer: Aetna Commercial |
$61.87
|
| Rate for Payer: Aetna Medicare |
$46.17
|
| Rate for Payer: BCBS Complete |
$80.00
|
| Rate for Payer: BCBS MAPPO |
$46.17
|
| Rate for Payer: BCN Medicare Advantage |
$46.17
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$66.48
|
| Rate for Payer: Cofinity Commercial |
$61.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.17
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Healthscope Whirlpool |
$55.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.48
|
| Rate for Payer: Nomi Health Commercial |
$55.40
|
| Rate for Payer: PACE SWMI |
$46.17
|
| Rate for Payer: PHP Medicare Advantage |
$46.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.00
|
| Rate for Payer: Priority Health Medicare |
$46.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.17
|
| Rate for Payer: UHC Medicare Advantage |
$46.17
|
| Rate for Payer: UHCCP DNSP |
$46.17
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 11307
|
| Min. Negotiated Rate |
$58.69 |
| Max. Negotiated Rate |
$154.05 |
| Rate for Payer: Aetna Commercial |
$78.64
|
| Rate for Payer: Aetna Medicare |
$58.69
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: BCBS MAPPO |
$58.69
|
| Rate for Payer: BCN Medicare Advantage |
$58.69
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$84.51
|
| Rate for Payer: Cofinity Commercial |
$78.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.69
|
| Rate for Payer: Healthscope Commercial |
$70.43
|
| Rate for Payer: Healthscope Whirlpool |
$70.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.62
|
| Rate for Payer: Nomi Health Commercial |
$70.43
|
| Rate for Payer: PACE SWMI |
$58.69
|
| Rate for Payer: PHP Medicare Advantage |
$58.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health Medicare |
$58.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.69
|
| Rate for Payer: UHC Medicare Advantage |
$58.69
|
| Rate for Payer: UHCCP DNSP |
$58.69
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 11308
|
| Min. Negotiated Rate |
$66.01 |
| Max. Negotiated Rate |
$163.15 |
| Rate for Payer: Aetna Commercial |
$88.45
|
| Rate for Payer: Aetna Medicare |
$66.01
|
| Rate for Payer: BCBS Complete |
$100.40
|
| Rate for Payer: BCBS MAPPO |
$66.01
|
| Rate for Payer: BCN Medicare Advantage |
$66.01
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$95.05
|
| Rate for Payer: Cofinity Commercial |
$88.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.01
|
| Rate for Payer: Healthscope Commercial |
$79.21
|
| Rate for Payer: Healthscope Whirlpool |
$79.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.31
|
| Rate for Payer: Nomi Health Commercial |
$79.21
|
| Rate for Payer: PACE SWMI |
$66.01
|
| Rate for Payer: PHP Medicare Advantage |
$66.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health Medicare |
$66.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.01
|
| Rate for Payer: UHC Medicare Advantage |
$66.01
|
| Rate for Payer: UHCCP DNSP |
$66.01
|
|
|
PR SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 11300
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$104.65 |
| Rate for Payer: Aetna Commercial |
$42.88
|
| Rate for Payer: Aetna Medicare |
$32.00
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$32.00
|
| Rate for Payer: BCN Medicare Advantage |
$32.00
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$46.08
|
| Rate for Payer: Cofinity Commercial |
$42.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.00
|
| Rate for Payer: Healthscope Commercial |
$38.40
|
| Rate for Payer: Healthscope Whirlpool |
$38.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.60
|
| Rate for Payer: Nomi Health Commercial |
$38.40
|
| Rate for Payer: PACE SWMI |
$32.00
|
| Rate for Payer: PHP Medicare Advantage |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Medicare |
$32.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.00
|
| Rate for Payer: UHC Medicare Advantage |
$32.00
|
| Rate for Payer: UHCCP DNSP |
$32.00
|
|
|
PR SHOE LIFTS ELEVATION HEEL /I
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS L3334
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$66.17 |
| Rate for Payer: Aetna Commercial |
$61.57
|
| Rate for Payer: Aetna Medicare |
$45.95
|
| Rate for Payer: BCBS Complete |
$26.00
|
| Rate for Payer: BCBS MAPPO |
$45.95
|
| Rate for Payer: BCN Medicare Advantage |
$45.95
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$66.17
|
| Rate for Payer: Cofinity Commercial |
$61.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.95
|
| Rate for Payer: Healthscope Commercial |
$55.14
|
| Rate for Payer: Healthscope Whirlpool |
$55.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.25
|
| Rate for Payer: Nomi Health Commercial |
$55.14
|
| Rate for Payer: PACE SWMI |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.25
|
| Rate for Payer: Priority Health Medicare |
$45.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.95
|
| Rate for Payer: UHC Medicare Advantage |
$45.95
|
| Rate for Payer: UHCCP DNSP |
$45.95
|
|
|
PR SHORTENING TENDON EXTENSOR HAND/FINGER EACH
|
Professional
|
Both
|
$1,208.00
|
|
|
Service Code
|
HCPCS 26477
|
| Min. Negotiated Rate |
$483.20 |
| Max. Negotiated Rate |
$842.49 |
| Rate for Payer: Aetna Commercial |
$783.98
|
| Rate for Payer: Aetna Medicare |
$585.06
|
| Rate for Payer: BCBS Complete |
$483.20
|
| Rate for Payer: BCBS MAPPO |
$585.06
|
| Rate for Payer: BCN Medicare Advantage |
$585.06
|
| Rate for Payer: Cash Price |
$966.40
|
| Rate for Payer: Cash Price |
$966.40
|
| Rate for Payer: Cofinity Commercial |
$842.49
|
| Rate for Payer: Cofinity Commercial |
$783.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.06
|
| Rate for Payer: Healthscope Commercial |
$702.07
|
| Rate for Payer: Healthscope Whirlpool |
$702.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$614.31
|
| Rate for Payer: Nomi Health Commercial |
$702.07
|
| Rate for Payer: PACE SWMI |
$585.06
|
| Rate for Payer: PHP Medicare Advantage |
$585.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.20
|
| Rate for Payer: Priority Health Medicare |
$585.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.06
|
| Rate for Payer: UHC Medicare Advantage |
$585.06
|
| Rate for Payer: UHCCP DNSP |
$585.06
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 95926
|
| Min. Negotiated Rate |
$126.04 |
| Max. Negotiated Rate |
$206.05 |
| Rate for Payer: Aetna Commercial |
$168.89
|
| Rate for Payer: Aetna Medicare |
$126.04
|
| Rate for Payer: BCBS Complete |
$126.80
|
| Rate for Payer: BCBS MAPPO |
$126.04
|
| Rate for Payer: BCN Medicare Advantage |
$126.04
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$181.50
|
| Rate for Payer: Cofinity Commercial |
$168.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.04
|
| Rate for Payer: Healthscope Commercial |
$151.25
|
| Rate for Payer: Healthscope Whirlpool |
$151.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.34
|
| Rate for Payer: Nomi Health Commercial |
$151.25
|
| Rate for Payer: PACE SWMI |
$126.04
|
| Rate for Payer: PHP Medicare Advantage |
$126.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.05
|
| Rate for Payer: Priority Health Medicare |
$126.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.04
|
| Rate for Payer: UHC Medicare Advantage |
$126.04
|
| Rate for Payer: UHCCP DNSP |
$126.04
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 95927
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$227.45 |
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Medicare |
$157.95
|
| Rate for Payer: Aetna Medicare |
$157.95
|
| Rate for Payer: BCBS Complete |
$115.20
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS MAPPO |
$157.95
|
| Rate for Payer: BCBS MAPPO |
$157.95
|
| Rate for Payer: BCN Medicare Advantage |
$157.95
|
| Rate for Payer: BCN Medicare Advantage |
$157.95
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cofinity Commercial |
$211.65
|
| Rate for Payer: Cofinity Commercial |
$227.45
|
| Rate for Payer: Cofinity Commercial |
$211.65
|
| Rate for Payer: Cofinity Commercial |
$227.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.95
|
| Rate for Payer: Healthscope Commercial |
$189.54
|
| Rate for Payer: Healthscope Commercial |
$189.54
|
| Rate for Payer: Healthscope Whirlpool |
$189.54
|
| Rate for Payer: Healthscope Whirlpool |
$189.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.85
|
| Rate for Payer: Nomi Health Commercial |
$189.54
|
| Rate for Payer: Nomi Health Commercial |
$189.54
|
| Rate for Payer: PACE SWMI |
$157.95
|
| Rate for Payer: PACE SWMI |
$157.95
|
| Rate for Payer: PHP Medicare Advantage |
$157.95
|
| Rate for Payer: PHP Medicare Advantage |
$157.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Medicare |
$157.95
|
| Rate for Payer: Priority Health Medicare |
$157.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.95
|
| Rate for Payer: UHC Medicare Advantage |
$157.95
|
| Rate for Payer: UHC Medicare Advantage |
$157.95
|
| Rate for Payer: UHCCP DNSP |
$157.95
|
| Rate for Payer: UHCCP DNSP |
$157.95
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 95925
|
| Min. Negotiated Rate |
$130.80 |
| Max. Negotiated Rate |
$212.55 |
| Rate for Payer: Aetna Commercial |
$184.40
|
| Rate for Payer: Aetna Medicare |
$137.61
|
| Rate for Payer: BCBS Complete |
$130.80
|
| Rate for Payer: BCBS MAPPO |
$137.61
|
| Rate for Payer: BCN Medicare Advantage |
$137.61
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$198.16
|
| Rate for Payer: Cofinity Commercial |
$184.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.61
|
| Rate for Payer: Healthscope Commercial |
$165.13
|
| Rate for Payer: Healthscope Whirlpool |
$165.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.49
|
| Rate for Payer: Nomi Health Commercial |
$165.13
|
| Rate for Payer: PACE SWMI |
$137.61
|
| Rate for Payer: PHP Medicare Advantage |
$137.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.55
|
| Rate for Payer: Priority Health Medicare |
$137.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.61
|
| Rate for Payer: UHC Medicare Advantage |
$137.61
|
| Rate for Payer: UHCCP DNSP |
$137.61
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 95938
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$478.53 |
| Rate for Payer: Aetna Commercial |
$445.30
|
| Rate for Payer: Aetna Medicare |
$332.31
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$332.31
|
| Rate for Payer: BCN Medicare Advantage |
$332.31
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$478.53
|
| Rate for Payer: Cofinity Commercial |
$445.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.31
|
| Rate for Payer: Healthscope Commercial |
$398.77
|
| Rate for Payer: Healthscope Whirlpool |
$398.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.93
|
| Rate for Payer: Nomi Health Commercial |
$398.77
|
| Rate for Payer: PACE SWMI |
$332.31
|
| Rate for Payer: PHP Medicare Advantage |
$332.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$332.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.31
|
| Rate for Payer: UHC Medicare Advantage |
$332.31
|
| Rate for Payer: UHCCP DNSP |
$332.31
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 11311
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$120.25 |
| Rate for Payer: Aetna Commercial |
$79.96
|
| Rate for Payer: Aetna Medicare |
$59.67
|
| Rate for Payer: BCBS Complete |
$74.00
|
| Rate for Payer: BCBS MAPPO |
$59.67
|
| Rate for Payer: BCN Medicare Advantage |
$59.67
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$85.92
|
| Rate for Payer: Cofinity Commercial |
$79.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Healthscope Whirlpool |
$71.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.65
|
| Rate for Payer: Nomi Health Commercial |
$71.60
|
| Rate for Payer: PACE SWMI |
$59.67
|
| Rate for Payer: PHP Medicare Advantage |
$59.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health Medicare |
$59.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.67
|
| Rate for Payer: UHC Medicare Advantage |
$59.67
|
| Rate for Payer: UHCCP DNSP |
$59.67
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 11312
|
| Min. Negotiated Rate |
$70.73 |
| Max. Negotiated Rate |
$172.90 |
| Rate for Payer: Aetna Commercial |
$94.78
|
| Rate for Payer: Aetna Medicare |
$70.73
|
| Rate for Payer: BCBS Complete |
$106.40
|
| Rate for Payer: BCBS MAPPO |
$70.73
|
| Rate for Payer: BCN Medicare Advantage |
$70.73
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$94.78
|
| Rate for Payer: Cofinity Commercial |
$101.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.73
|
| Rate for Payer: Healthscope Commercial |
$84.88
|
| Rate for Payer: Healthscope Whirlpool |
$84.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.27
|
| Rate for Payer: Nomi Health Commercial |
$84.88
|
| Rate for Payer: PACE SWMI |
$70.73
|
| Rate for Payer: PHP Medicare Advantage |
$70.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health Medicare |
$70.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.73
|
| Rate for Payer: UHC Medicare Advantage |
$70.73
|
| Rate for Payer: UHCCP DNSP |
$70.73
|
|
