|
PR TESTOSTERONE CYPIONAT 100 MG
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1070
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
|
|
PR TESTOSTERONE CYPIONAT 200 MG
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS J1080
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
|
|
PR TESTOSTERONE CYPIONATE 1 ML
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS J1060
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.50
|
|
|
PR TESTOSTERONE ENANTHATE INJ
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS J3130
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
|
|
PR TESTOSTERONE PELLET 75 MG
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS S0189
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$106.79 |
| Rate for Payer: Aetna Commercial |
$100.93
|
| Rate for Payer: BCBS Complete |
$50.40
|
| Rate for Payer: BCN Commercial |
$106.79
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
|
|
PR TESTOSTERONE UNDECANOATE 1MG
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J3145
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Aetna Commercial |
$2.85
|
| Rate for Payer: Aetna Medicare |
$2.13
|
| Rate for Payer: BCBS MAPPO |
$2.13
|
| Rate for Payer: BCBS Trust/PPO |
$2.10
|
| Rate for Payer: BCN Commercial |
$2.06
|
| Rate for Payer: BCN Medicare Advantage |
$2.13
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$3.07
|
| Rate for Payer: Cofinity Commercial |
$2.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.13
|
| Rate for Payer: Healthscope Commercial |
$2.56
|
| Rate for Payer: Healthscope Whirlpool |
$2.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.34
|
| Rate for Payer: Nomi Health Commercial |
$2.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
| Rate for Payer: PACE SWMI |
$2.13
|
| Rate for Payer: PHP Medicare Advantage |
$2.13
|
| Rate for Payer: Priority Health Medicare |
$2.13
|
| Rate for Payer: Railroad Medicare Medicare |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.07
|
| Rate for Payer: UHCCP DNSP |
$2.13
|
|
|
PR TETANUS IMMUNIZATION, IM
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 90703
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
|
|
PR THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 97530
|
| Min. Negotiated Rate |
$33.37 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$44.72
|
| Rate for Payer: Aetna Medicare |
$33.37
|
| Rate for Payer: BCBS MAPPO |
$33.37
|
| Rate for Payer: BCN Commercial |
$35.72
|
| Rate for Payer: BCN Medicare Advantage |
$33.37
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$48.05
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.37
|
| Rate for Payer: Healthscope Commercial |
$40.04
|
| Rate for Payer: Healthscope Whirlpool |
$40.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.71
|
| Rate for Payer: Nomi Health Commercial |
$40.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.50
|
| Rate for Payer: PACE SWMI |
$33.37
|
| Rate for Payer: PHP Medicare Advantage |
$33.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$33.37
|
| Rate for Payer: Priority Health Narrow Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$33.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.37
|
| Rate for Payer: UHC Exchange |
$34.56
|
| Rate for Payer: UHCCP DNSP |
$33.37
|
|
|
PR THERAPEUTIC APHERESIS PLASMA PHERESIS
|
Professional
|
Both
|
$895.00
|
|
|
Service Code
|
HCPCS 36514
|
| Min. Negotiated Rate |
$49.84 |
| Max. Negotiated Rate |
$671.25 |
| Rate for Payer: Aetna Commercial |
$104.02
|
| Rate for Payer: Aetna Medicare |
$77.63
|
| Rate for Payer: BCBS Complete |
$52.33
|
| Rate for Payer: BCBS MAPPO |
$77.63
|
| Rate for Payer: BCN Commercial |
$137.94
|
| Rate for Payer: BCN Medicare Advantage |
$77.63
|
| Rate for Payer: Cash Price |
$716.00
|
| Rate for Payer: Cash Price |
$716.00
|
| Rate for Payer: Cofinity Commercial |
$111.79
|
| Rate for Payer: Cofinity Commercial |
$104.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.63
|
| Rate for Payer: Healthscope Commercial |
$93.16
|
| Rate for Payer: Healthscope Whirlpool |
$93.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.51
|
| Rate for Payer: Meridian Medicaid |
$52.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.39
|
| Rate for Payer: Nomi Health Commercial |
$93.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.25
|
| Rate for Payer: PACE SWMI |
$77.63
|
| Rate for Payer: PHP Medicare Advantage |
$77.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$148.34
|
| Rate for Payer: Priority Health Medicare |
$77.63
|
| Rate for Payer: Priority Health Narrow Network |
$148.34
|
| Rate for Payer: Railroad Medicare Medicare |
$77.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$77.63
|
| Rate for Payer: UHC Exchange |
$168.47
|
| Rate for Payer: UHC Medicaid |
$49.84
|
| Rate for Payer: UHCCP DNSP |
$77.63
|
| Rate for Payer: UHCCP Medicaid |
$49.84
|
|
|
PR THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS 97150
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$23.29
|
| Rate for Payer: Aetna Medicare |
$17.38
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: BCBS MAPPO |
$17.38
|
| Rate for Payer: BCN Commercial |
$18.03
|
| Rate for Payer: BCN Medicare Advantage |
$17.38
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cofinity Commercial |
$25.03
|
| Rate for Payer: Cofinity Commercial |
$23.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.38
|
| Rate for Payer: Healthscope Commercial |
$20.86
|
| Rate for Payer: Healthscope Whirlpool |
$20.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.12
|
| Rate for Payer: Nomi Health Commercial |
$20.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.25
|
| Rate for Payer: PACE SWMI |
$17.38
|
| Rate for Payer: PHP Medicare Advantage |
$17.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$17.38
|
| Rate for Payer: Priority Health Narrow Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$17.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.38
|
| Rate for Payer: UHC Exchange |
$16.28
|
| Rate for Payer: UHCCP DNSP |
$17.38
|
|
|
PR THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 96372
|
| Min. Negotiated Rate |
$14.35 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Aetna Commercial |
$19.55
|
| Rate for Payer: Aetna Medicare |
$14.59
|
| Rate for Payer: BCBS MAPPO |
$14.59
|
| Rate for Payer: BCN Commercial |
$14.35
|
| Rate for Payer: BCN Medicare Advantage |
$14.59
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$19.55
|
| Rate for Payer: Cofinity Commercial |
$21.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.59
|
| Rate for Payer: Healthscope Commercial |
$17.51
|
| Rate for Payer: Healthscope Whirlpool |
$17.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.05
|
| Rate for Payer: Nomi Health Commercial |
$17.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.75
|
| Rate for Payer: PACE SWMI |
$14.59
|
| Rate for Payer: PHP Medicare Advantage |
$14.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19.75
|
| Rate for Payer: Priority Health Medicare |
$14.59
|
| Rate for Payer: Priority Health Narrow Network |
$19.75
|
| Rate for Payer: Railroad Medicare Medicare |
$14.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.59
|
| Rate for Payer: UHC Exchange |
$22.15
|
| Rate for Payer: UHCCP DNSP |
$14.59
|
|
|
PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 97110
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: Aetna Medicare |
$27.91
|
| Rate for Payer: BCBS MAPPO |
$27.91
|
| Rate for Payer: BCN Commercial |
$29.70
|
| Rate for Payer: BCN Medicare Advantage |
$27.91
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$37.40
|
| Rate for Payer: Cofinity Commercial |
$40.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.91
|
| Rate for Payer: Healthscope Commercial |
$33.49
|
| Rate for Payer: Healthscope Whirlpool |
$33.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.70
|
| Rate for Payer: Nomi Health Commercial |
$33.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
| Rate for Payer: PACE SWMI |
$27.91
|
| Rate for Payer: PHP Medicare Advantage |
$27.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$27.91
|
| Rate for Payer: Priority Health Narrow Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$27.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.91
|
| Rate for Payer: UHC Exchange |
$27.15
|
| Rate for Payer: UHCCP DNSP |
$27.91
|
|
|
PR THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 62329
|
| Min. Negotiated Rate |
$59.21 |
| Max. Negotiated Rate |
$200.41 |
| Rate for Payer: Aetna Commercial |
$124.69
|
| Rate for Payer: Aetna Medicare |
$93.05
|
| Rate for Payer: BCBS Complete |
$62.17
|
| Rate for Payer: BCBS MAPPO |
$93.05
|
| Rate for Payer: BCN Commercial |
$154.87
|
| Rate for Payer: BCN Medicare Advantage |
$93.05
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$133.99
|
| Rate for Payer: Cofinity Commercial |
$124.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.05
|
| Rate for Payer: Healthscope Commercial |
$111.66
|
| Rate for Payer: Healthscope Whirlpool |
$111.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.70
|
| Rate for Payer: Meridian Medicaid |
$62.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.36
|
| Rate for Payer: Nomi Health Commercial |
$111.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.25
|
| Rate for Payer: PACE SWMI |
$93.05
|
| Rate for Payer: PHP Medicare Advantage |
$93.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$179.89
|
| Rate for Payer: Priority Health Medicare |
$93.05
|
| Rate for Payer: Priority Health Narrow Network |
$179.89
|
| Rate for Payer: Railroad Medicare Medicare |
$93.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$200.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.05
|
| Rate for Payer: UHC Exchange |
$200.41
|
| Rate for Payer: UHC Medicaid |
$59.21
|
| Rate for Payer: UHCCP DNSP |
$93.05
|
| Rate for Payer: UHCCP Medicaid |
$59.21
|
|
|
PR THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 62272
|
| Min. Negotiated Rate |
$54.10 |
| Max. Negotiated Rate |
$363.75 |
| Rate for Payer: Aetna Commercial |
$114.33
|
| Rate for Payer: Aetna Medicare |
$85.32
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS MAPPO |
$85.32
|
| Rate for Payer: BCN Commercial |
$139.93
|
| Rate for Payer: BCN Medicare Advantage |
$85.32
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cofinity Commercial |
$122.86
|
| Rate for Payer: Cofinity Commercial |
$114.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.32
|
| Rate for Payer: Healthscope Commercial |
$102.38
|
| Rate for Payer: Healthscope Whirlpool |
$102.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.59
|
| Rate for Payer: Meridian Medicaid |
$56.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.85
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$363.75
|
| Rate for Payer: PACE SWMI |
$85.32
|
| Rate for Payer: PHP Medicare Advantage |
$85.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$162.52
|
| Rate for Payer: Priority Health Medicare |
$85.32
|
| Rate for Payer: Priority Health Narrow Network |
$162.52
|
| Rate for Payer: Railroad Medicare Medicare |
$85.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.32
|
| Rate for Payer: UHC Exchange |
$156.06
|
| Rate for Payer: UHC Medicaid |
$54.10
|
| Rate for Payer: UHCCP DNSP |
$85.32
|
| Rate for Payer: UHCCP Medicaid |
$54.10
|
|
|
PR THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC
|
Professional
|
Both
|
$880.00
|
|
|
Service Code
|
HCPCS 64628
|
| Min. Negotiated Rate |
$232.60 |
| Max. Negotiated Rate |
$827.09 |
| Rate for Payer: Aetna Commercial |
$480.32
|
| Rate for Payer: Aetna Medicare |
$358.45
|
| Rate for Payer: BCBS Complete |
$244.23
|
| Rate for Payer: BCBS MAPPO |
$358.45
|
| Rate for Payer: BCN Commercial |
$614.51
|
| Rate for Payer: BCN Medicare Advantage |
$358.45
|
| Rate for Payer: Cash Price |
$704.00
|
| Rate for Payer: Cash Price |
$704.00
|
| Rate for Payer: Cofinity Commercial |
$516.17
|
| Rate for Payer: Cofinity Commercial |
$480.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.45
|
| Rate for Payer: Healthscope Commercial |
$430.14
|
| Rate for Payer: Healthscope Whirlpool |
$430.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.37
|
| Rate for Payer: Meridian Medicaid |
$244.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$394.30
|
| Rate for Payer: Nomi Health Commercial |
$430.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.00
|
| Rate for Payer: PACE SWMI |
$358.45
|
| Rate for Payer: PHP Medicare Advantage |
$358.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$713.75
|
| Rate for Payer: Priority Health Medicare |
$358.45
|
| Rate for Payer: Priority Health Narrow Network |
$713.75
|
| Rate for Payer: Railroad Medicare Medicare |
$358.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$827.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$358.45
|
| Rate for Payer: UHC Exchange |
$827.09
|
| Rate for Payer: UHC Medicaid |
$232.60
|
| Rate for Payer: UHCCP DNSP |
$358.45
|
| Rate for Payer: UHCCP Medicaid |
$232.60
|
|
|
PR THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG
|
Professional
|
Both
|
$110.00
|
|
|
Service Code
|
HCPCS 96374
|
| Min. Negotiated Rate |
$35.13 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Aetna Commercial |
$47.07
|
| Rate for Payer: Aetna Medicare |
$35.13
|
| Rate for Payer: BCBS MAPPO |
$35.13
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Medicare Advantage |
$35.13
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$47.07
|
| Rate for Payer: Cofinity Commercial |
$50.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.13
|
| Rate for Payer: Healthscope Commercial |
$42.16
|
| Rate for Payer: Healthscope Whirlpool |
$42.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.64
|
| Rate for Payer: Nomi Health Commercial |
$42.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.50
|
| Rate for Payer: PACE SWMI |
$35.13
|
| Rate for Payer: PHP Medicare Advantage |
$35.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$48.22
|
| Rate for Payer: Priority Health Medicare |
$35.13
|
| Rate for Payer: Priority Health Narrow Network |
$48.22
|
| Rate for Payer: Railroad Medicare Medicare |
$35.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.13
|
| Rate for Payer: UHC Exchange |
$60.00
|
| Rate for Payer: UHCCP DNSP |
$35.13
|
|
|
PR THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 97112
|
| Min. Negotiated Rate |
$31.16 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$42.09
|
| Rate for Payer: Aetna Medicare |
$31.41
|
| Rate for Payer: BCBS MAPPO |
$31.41
|
| Rate for Payer: BCN Commercial |
$33.04
|
| Rate for Payer: BCN Medicare Advantage |
$31.41
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$42.09
|
| Rate for Payer: Cofinity Commercial |
$45.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.41
|
| Rate for Payer: Healthscope Commercial |
$37.69
|
| Rate for Payer: Healthscope Whirlpool |
$37.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.55
|
| Rate for Payer: Nomi Health Commercial |
$37.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.75
|
| Rate for Payer: PACE SWMI |
$31.41
|
| Rate for Payer: PHP Medicare Advantage |
$31.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$31.41
|
| Rate for Payer: Priority Health Narrow Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$31.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.41
|
| Rate for Payer: UHC Exchange |
$31.16
|
| Rate for Payer: UHCCP DNSP |
$31.41
|
|
|
PR THER PX 1/> AREAS EACH 15 MINUTES MASSAGE
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 97124
|
| Min. Negotiated Rate |
$14.38 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$37.83
|
| Rate for Payer: Aetna Medicare |
$28.23
|
| Rate for Payer: BCBS MAPPO |
$28.23
|
| Rate for Payer: BCN Commercial |
$14.38
|
| Rate for Payer: BCN Medicare Advantage |
$28.23
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$37.83
|
| Rate for Payer: Cofinity Commercial |
$40.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.23
|
| Rate for Payer: Healthscope Commercial |
$33.88
|
| Rate for Payer: Healthscope Whirlpool |
$33.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.05
|
| Rate for Payer: Nomi Health Commercial |
$33.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$28.23
|
| Rate for Payer: PHP Medicare Advantage |
$28.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$28.23
|
| Rate for Payer: Priority Health Narrow Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$28.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.23
|
| Rate for Payer: UHC Exchange |
$25.66
|
| Rate for Payer: UHCCP DNSP |
$28.23
|
|
|
PR THIGHPLASTY
|
Professional
|
Both
|
$6,309.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,523.60 |
| Max. Negotiated Rate |
$4,731.75 |
| Rate for Payer: BCBS Complete |
$2,523.60
|
| Rate for Payer: Cash Price |
$5,047.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,731.75
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING
|
Professional
|
Both
|
$545.00
|
|
|
Service Code
|
HCPCS 32555
|
| Min. Negotiated Rate |
$59.85 |
| Max. Negotiated Rate |
$408.75 |
| Rate for Payer: Aetna Commercial |
$125.56
|
| Rate for Payer: Aetna Medicare |
$93.70
|
| Rate for Payer: BCBS Complete |
$62.84
|
| Rate for Payer: BCBS MAPPO |
$93.70
|
| Rate for Payer: BCN Commercial |
$159.85
|
| Rate for Payer: BCN Medicare Advantage |
$93.70
|
| Rate for Payer: Cash Price |
$436.00
|
| Rate for Payer: Cash Price |
$436.00
|
| Rate for Payer: Cofinity Commercial |
$134.93
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.70
|
| Rate for Payer: Healthscope Commercial |
$112.44
|
| Rate for Payer: Healthscope Whirlpool |
$112.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.39
|
| Rate for Payer: Meridian Medicaid |
$62.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.07
|
| Rate for Payer: Nomi Health Commercial |
$112.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$408.75
|
| Rate for Payer: PACE SWMI |
$93.70
|
| Rate for Payer: PHP Medicare Advantage |
$93.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$150.53
|
| Rate for Payer: Priority Health Medicare |
$93.70
|
| Rate for Payer: Priority Health Narrow Network |
$150.53
|
| Rate for Payer: Railroad Medicare Medicare |
$93.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.70
|
| Rate for Payer: UHC Exchange |
$198.13
|
| Rate for Payer: UHC Medicaid |
$59.85
|
| Rate for Payer: UHCCP DNSP |
$93.70
|
| Rate for Payer: UHCCP Medicaid |
$59.85
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 32554
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$587.25 |
| Rate for Payer: Aetna Commercial |
$105.77
|
| Rate for Payer: Aetna Medicare |
$78.93
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS MAPPO |
$78.93
|
| Rate for Payer: BCN Commercial |
$129.97
|
| Rate for Payer: BCN Medicare Advantage |
$78.93
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$113.66
|
| Rate for Payer: Cofinity Commercial |
$105.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.93
|
| Rate for Payer: Healthscope Commercial |
$94.72
|
| Rate for Payer: Healthscope Whirlpool |
$94.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.88
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.82
|
| Rate for Payer: Nomi Health Commercial |
$94.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$587.25
|
| Rate for Payer: PACE SWMI |
$78.93
|
| Rate for Payer: PHP Medicare Advantage |
$78.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$122.39
|
| Rate for Payer: Priority Health Medicare |
$78.93
|
| Rate for Payer: Priority Health Narrow Network |
$122.39
|
| Rate for Payer: Railroad Medicare Medicare |
$78.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.93
|
| Rate for Payer: UHC Exchange |
$159.54
|
| Rate for Payer: UHC Medicaid |
$50.48
|
| Rate for Payer: UHCCP DNSP |
$78.93
|
| Rate for Payer: UHCCP Medicaid |
$50.48
|
|
|
PR THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL
|
Professional
|
Both
|
$2,688.00
|
|
|
Service Code
|
HCPCS 32905
|
| Min. Negotiated Rate |
$808.34 |
| Max. Negotiated Rate |
$2,367.86 |
| Rate for Payer: Aetna Commercial |
$1,694.50
|
| Rate for Payer: Aetna Medicare |
$1,264.55
|
| Rate for Payer: BCBS Complete |
$848.76
|
| Rate for Payer: BCBS MAPPO |
$1,264.55
|
| Rate for Payer: BCN Commercial |
$1,973.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,264.55
|
| Rate for Payer: Cash Price |
$2,150.40
|
| Rate for Payer: Cash Price |
$2,150.40
|
| Rate for Payer: Cofinity Commercial |
$1,820.95
|
| Rate for Payer: Cofinity Commercial |
$1,694.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,264.55
|
| Rate for Payer: Healthscope Commercial |
$1,517.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,517.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,327.78
|
| Rate for Payer: Meridian Medicaid |
$848.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,391.01
|
| Rate for Payer: Nomi Health Commercial |
$1,517.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,016.00
|
| Rate for Payer: PACE SWMI |
$1,264.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,264.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,857.98
|
| Rate for Payer: Priority Health Medicare |
$1,264.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,857.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,264.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,367.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,264.55
|
| Rate for Payer: UHC Exchange |
$2,367.86
|
| Rate for Payer: UHC Medicaid |
$808.34
|
| Rate for Payer: UHCCP DNSP |
$1,264.55
|
| Rate for Payer: UHCCP Medicaid |
$808.34
|
|
|
PR THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL
|
Professional
|
Both
|
$3,328.00
|
|
|
Service Code
|
HCPCS 32906
|
| Min. Negotiated Rate |
$989.39 |
| Max. Negotiated Rate |
$2,930.14 |
| Rate for Payer: Aetna Commercial |
$2,079.05
|
| Rate for Payer: Aetna Medicare |
$1,551.53
|
| Rate for Payer: BCBS Complete |
$1,038.86
|
| Rate for Payer: BCBS MAPPO |
$1,551.53
|
| Rate for Payer: BCN Commercial |
$2,429.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,551.53
|
| Rate for Payer: Cash Price |
$2,662.40
|
| Rate for Payer: Cash Price |
$2,662.40
|
| Rate for Payer: Cofinity Commercial |
$2,234.20
|
| Rate for Payer: Cofinity Commercial |
$2,079.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,551.53
|
| Rate for Payer: Healthscope Commercial |
$1,861.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,861.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,629.11
|
| Rate for Payer: Meridian Medicaid |
$1,038.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,706.68
|
| Rate for Payer: Nomi Health Commercial |
$1,861.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,496.00
|
| Rate for Payer: PACE SWMI |
$1,551.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,551.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$989.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,288.02
|
| Rate for Payer: Priority Health Medicare |
$1,551.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,288.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,551.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,930.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,551.53
|
| Rate for Payer: UHC Exchange |
$2,930.14
|
| Rate for Payer: UHC Medicaid |
$989.39
|
| Rate for Payer: UHCCP DNSP |
$1,551.53
|
| Rate for Payer: UHCCP Medicaid |
$989.39
|
|
|
PR THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE
|
Professional
|
Both
|
$2,441.00
|
|
|
Service Code
|
HCPCS 32654
|
| Min. Negotiated Rate |
$719.30 |
| Max. Negotiated Rate |
$2,059.57 |
| Rate for Payer: Aetna Commercial |
$1,504.57
|
| Rate for Payer: Aetna Medicare |
$1,122.81
|
| Rate for Payer: BCBS Complete |
$755.26
|
| Rate for Payer: BCBS MAPPO |
$1,122.81
|
| Rate for Payer: BCN Commercial |
$1,774.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,122.81
|
| Rate for Payer: Cash Price |
$1,952.80
|
| Rate for Payer: Cash Price |
$1,952.80
|
| Rate for Payer: Cofinity Commercial |
$1,616.85
|
| Rate for Payer: Cofinity Commercial |
$1,504.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,122.81
|
| Rate for Payer: Healthscope Commercial |
$1,347.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,347.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,178.95
|
| Rate for Payer: Meridian Medicaid |
$755.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,235.09
|
| Rate for Payer: Nomi Health Commercial |
$1,347.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,830.75
|
| Rate for Payer: PACE SWMI |
$1,122.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,122.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$719.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,670.88
|
| Rate for Payer: Priority Health Medicare |
$1,122.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,670.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,122.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,059.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,122.81
|
| Rate for Payer: UHC Exchange |
$2,059.57
|
| Rate for Payer: UHC Medicaid |
$719.30
|
| Rate for Payer: UHCCP DNSP |
$1,122.81
|
| Rate for Payer: UHCCP Medicaid |
$719.30
|
|
|
PR THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX
|
Professional
|
Both
|
$1,455.00
|
|
|
Service Code
|
HCPCS 32606
|
| Min. Negotiated Rate |
$273.28 |
| Max. Negotiated Rate |
$1,091.25 |
| Rate for Payer: Aetna Commercial |
$575.95
|
| Rate for Payer: Aetna Medicare |
$429.81
|
| Rate for Payer: BCBS Complete |
$286.94
|
| Rate for Payer: BCBS MAPPO |
$429.81
|
| Rate for Payer: BCN Commercial |
$680.74
|
| Rate for Payer: BCN Medicare Advantage |
$429.81
|
| Rate for Payer: Cash Price |
$1,164.00
|
| Rate for Payer: Cash Price |
$1,164.00
|
| Rate for Payer: Cofinity Commercial |
$618.93
|
| Rate for Payer: Cofinity Commercial |
$575.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$429.81
|
| Rate for Payer: Healthscope Commercial |
$515.77
|
| Rate for Payer: Healthscope Whirlpool |
$515.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$451.30
|
| Rate for Payer: Meridian Medicaid |
$286.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$472.79
|
| Rate for Payer: Nomi Health Commercial |
$515.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,091.25
|
| Rate for Payer: PACE SWMI |
$429.81
|
| Rate for Payer: PHP Medicare Advantage |
$429.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$641.06
|
| Rate for Payer: Priority Health Medicare |
$429.81
|
| Rate for Payer: Priority Health Narrow Network |
$641.06
|
| Rate for Payer: Railroad Medicare Medicare |
$429.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$823.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$429.81
|
| Rate for Payer: UHC Exchange |
$823.65
|
| Rate for Payer: UHC Medicaid |
$273.28
|
| Rate for Payer: UHCCP DNSP |
$429.81
|
| Rate for Payer: UHCCP Medicaid |
$273.28
|
|
