|
PR INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT
|
Professional
|
$52.04
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
Z13142
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$62.45 |
| Rate for Payer: Aetna Medicare |
$13.33
|
| Rate for Payer: Anthem Exchange |
$15.87
|
| Rate for Payer: Anthem Medicare |
$13.33
|
| Rate for Payer: Anthem PPO |
$15.87
|
| Rate for Payer: Anthem Traditional |
$15.87
|
| Rate for Payer: Caresource Just 4 Me |
$15.33
|
| Rate for Payer: Caresource Medicare |
$14.66
|
| Rate for Payer: Centivo/Paragon All Products |
$20.66
|
| Rate for Payer: Coventry/First Health All Products |
$62.45
|
| Rate for Payer: Frontpath All Products |
$15.22
|
| Rate for Payer: Humana ChoiceCare |
$52.04
|
| Rate for Payer: Humana Medicare |
$13.33
|
| Rate for Payer: Lucent/Coldwater Veneers |
$22.66
|
| Rate for Payer: Lutheran Preferred All Products |
$17.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$39.03
|
| Rate for Payer: PHP All Products |
$19.51
|
| Rate for Payer: Plain Church Group Ministry All Products |
$13.33
|
| Rate for Payer: Signature Care EPO |
$22.98
|
| Rate for Payer: Signature Care PPO |
$22.98
|
| Rate for Payer: Three Rivers Preferred All Products |
$16.00
|
| Rate for Payer: United Healthcare Commercial |
$24.49
|
| Rate for Payer: United Healthcare Medicare |
$13.01
|
|
|
PR INJECT PLATELET RICH PLASMA W/IMG HARVEST/PREPARATOIN
|
Professional
|
$825.00
|
|
|
Service Code
|
CPT 0232T
|
| Hospital Charge Code |
Z13241
|
| Min. Negotiated Rate |
$56.25 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Coventry/First Health All Products |
$990.00
|
| Rate for Payer: Frontpath All Products |
$188.36
|
| Rate for Payer: Humana ChoiceCare |
$825.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$618.75
|
| Rate for Payer: United Healthcare Commercial |
$56.25
|
|
|
PR INJECT TENDON ORIGIN/INSERT
|
Professional
|
$211.48
|
|
|
Service Code
|
CPT 20551
|
| Hospital Charge Code |
Z12122
|
| Min. Negotiated Rate |
$36.60 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Medicare |
$36.60
|
| Rate for Payer: Anthem Exchange |
$79.70
|
| Rate for Payer: Anthem Medicare |
$36.60
|
| Rate for Payer: Anthem PPO |
$79.70
|
| Rate for Payer: Anthem Traditional |
$79.70
|
| Rate for Payer: Caresource Just 4 Me |
$42.09
|
| Rate for Payer: Caresource Medicare |
$40.26
|
| Rate for Payer: Centivo/Paragon All Products |
$56.73
|
| Rate for Payer: Coventry/First Health All Products |
$253.78
|
| Rate for Payer: Frontpath All Products |
$50.91
|
| Rate for Payer: Humana ChoiceCare |
$211.48
|
| Rate for Payer: Humana Medicare |
$36.60
|
| Rate for Payer: Lucent/Coldwater Veneers |
$62.22
|
| Rate for Payer: Lutheran Preferred All Products |
$59.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$158.61
|
| Rate for Payer: PHP All Products |
$62.12
|
| Rate for Payer: Plain Church Group Ministry All Products |
$36.60
|
| Rate for Payer: Signature Care EPO |
$81.60
|
| Rate for Payer: Signature Care PPO |
$81.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$55.00
|
| Rate for Payer: United Healthcare Commercial |
$48.39
|
| Rate for Payer: United Healthcare Medicare |
$52.87
|
|
|
PR INJECT TENDON ORIGIN/INSERT
|
Professional
|
$105.74
|
|
|
Service Code
|
CPT 20551
|
| Hospital Charge Code |
Z12121
|
| Min. Negotiated Rate |
$36.60 |
| Max. Negotiated Rate |
$126.89 |
| Rate for Payer: Aetna Medicare |
$36.60
|
| Rate for Payer: Anthem Exchange |
$79.70
|
| Rate for Payer: Anthem Medicare |
$36.60
|
| Rate for Payer: Anthem PPO |
$79.70
|
| Rate for Payer: Anthem Traditional |
$79.70
|
| Rate for Payer: Caresource Just 4 Me |
$42.09
|
| Rate for Payer: Caresource Medicare |
$40.26
|
| Rate for Payer: Centivo/Paragon All Products |
$56.73
|
| Rate for Payer: Coventry/First Health All Products |
$126.89
|
| Rate for Payer: Frontpath All Products |
$50.91
|
| Rate for Payer: Humana ChoiceCare |
$105.74
|
| Rate for Payer: Humana Medicare |
$36.60
|
| Rate for Payer: Lucent/Coldwater Veneers |
$62.22
|
| Rate for Payer: Lutheran Preferred All Products |
$59.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$79.30
|
| Rate for Payer: PHP All Products |
$62.12
|
| Rate for Payer: Plain Church Group Ministry All Products |
$36.60
|
| Rate for Payer: Signature Care EPO |
$81.60
|
| Rate for Payer: Signature Care PPO |
$81.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$55.00
|
| Rate for Payer: United Healthcare Commercial |
$48.39
|
| Rate for Payer: United Healthcare Medicare |
$52.87
|
|
|
PR INJECT TENDON SHEATH/LIGAMENT
|
Professional
|
$105.74
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
Z12120
|
| Min. Negotiated Rate |
$36.60 |
| Max. Negotiated Rate |
$126.89 |
| Rate for Payer: Aetna Medicare |
$36.60
|
| Rate for Payer: Anthem Exchange |
$77.76
|
| Rate for Payer: Anthem Medicare |
$36.60
|
| Rate for Payer: Anthem PPO |
$77.76
|
| Rate for Payer: Anthem Traditional |
$77.76
|
| Rate for Payer: Caresource Just 4 Me |
$42.09
|
| Rate for Payer: Caresource Medicare |
$40.26
|
| Rate for Payer: Centivo/Paragon All Products |
$56.73
|
| Rate for Payer: Coventry/First Health All Products |
$126.89
|
| Rate for Payer: Frontpath All Products |
$50.99
|
| Rate for Payer: Humana ChoiceCare |
$105.74
|
| Rate for Payer: Humana Medicare |
$36.60
|
| Rate for Payer: Lucent/Coldwater Veneers |
$62.22
|
| Rate for Payer: Lutheran Preferred All Products |
$59.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$79.30
|
| Rate for Payer: PHP All Products |
$57.12
|
| Rate for Payer: Plain Church Group Ministry All Products |
$36.60
|
| Rate for Payer: Signature Care EPO |
$83.30
|
| Rate for Payer: Signature Care PPO |
$83.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$55.00
|
| Rate for Payer: United Healthcare Commercial |
$47.41
|
| Rate for Payer: United Healthcare Medicare |
$52.87
|
|
|
PR INJECT TRIGGER POINT, 1 OR 2
|
Professional
|
$96.76
|
|
|
Service Code
|
CPT 20552
|
| Hospital Charge Code |
Z12123
|
| Min. Negotiated Rate |
$34.77 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna Medicare |
$34.77
|
| Rate for Payer: Anthem Exchange |
$79.70
|
| Rate for Payer: Anthem Medicare |
$34.77
|
| Rate for Payer: Anthem PPO |
$79.70
|
| Rate for Payer: Anthem Traditional |
$79.70
|
| Rate for Payer: Caresource Just 4 Me |
$39.99
|
| Rate for Payer: Caresource Medicare |
$38.25
|
| Rate for Payer: Centivo/Paragon All Products |
$53.89
|
| Rate for Payer: Coventry/First Health All Products |
$116.11
|
| Rate for Payer: Frontpath All Products |
$48.91
|
| Rate for Payer: Humana ChoiceCare |
$96.76
|
| Rate for Payer: Humana Medicare |
$34.77
|
| Rate for Payer: Lucent/Coldwater Veneers |
$59.11
|
| Rate for Payer: Lutheran Preferred All Products |
$56.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$72.57
|
| Rate for Payer: PHP All Products |
$54.27
|
| Rate for Payer: Plain Church Group Ministry All Products |
$34.77
|
| Rate for Payer: Signature Care EPO |
$79.05
|
| Rate for Payer: Signature Care PPO |
$79.05
|
| Rate for Payer: Three Rivers Preferred All Products |
$52.00
|
| Rate for Payer: United Healthcare Commercial |
$41.04
|
| Rate for Payer: United Healthcare Medicare |
$48.38
|
|
|
PR INJ,LUMB EPIDUR,BLOOD/CLOT PATCH
|
Professional
|
$309.90
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
Z12823
|
| Min. Negotiated Rate |
$106.34 |
| Max. Negotiated Rate |
$371.88 |
| Rate for Payer: Aetna Medicare |
$106.34
|
| Rate for Payer: Anthem Exchange |
$164.60
|
| Rate for Payer: Anthem Medicare |
$106.34
|
| Rate for Payer: Anthem PPO |
$164.60
|
| Rate for Payer: Anthem Traditional |
$164.60
|
| Rate for Payer: Caresource Just 4 Me |
$122.29
|
| Rate for Payer: Caresource Medicare |
$116.97
|
| Rate for Payer: Centivo/Paragon All Products |
$164.83
|
| Rate for Payer: Coventry/First Health All Products |
$371.88
|
| Rate for Payer: Frontpath All Products |
$146.08
|
| Rate for Payer: Humana ChoiceCare |
$309.90
|
| Rate for Payer: Humana Medicare |
$106.34
|
| Rate for Payer: Lucent/Coldwater Veneers |
$180.78
|
| Rate for Payer: Lutheran Preferred All Products |
$170.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$232.42
|
| Rate for Payer: PHP All Products |
$166.00
|
| Rate for Payer: Plain Church Group Ministry All Products |
$106.34
|
| Rate for Payer: Signature Care EPO |
$272.54
|
| Rate for Payer: Signature Care PPO |
$272.54
|
| Rate for Payer: Three Rivers Preferred All Products |
$160.00
|
| Rate for Payer: United Healthcare Commercial |
$126.51
|
| Rate for Payer: United Healthcare Medicare |
$154.95
|
|
|
PR INSERT AND REMOVE BONE PIN
|
Professional
|
$412.94
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
Z12137
|
| Min. Negotiated Rate |
$152.97 |
| Max. Negotiated Rate |
$495.53 |
| Rate for Payer: Aetna Medicare |
$152.97
|
| Rate for Payer: Anthem Exchange |
$226.50
|
| Rate for Payer: Anthem Medicare |
$152.97
|
| Rate for Payer: Anthem PPO |
$226.50
|
| Rate for Payer: Anthem Traditional |
$226.50
|
| Rate for Payer: Caresource Just 4 Me |
$175.92
|
| Rate for Payer: Caresource Medicare |
$168.27
|
| Rate for Payer: Centivo/Paragon All Products |
$237.10
|
| Rate for Payer: Coventry/First Health All Products |
$495.53
|
| Rate for Payer: Frontpath All Products |
$207.21
|
| Rate for Payer: Humana ChoiceCare |
$412.94
|
| Rate for Payer: Humana Medicare |
$152.97
|
| Rate for Payer: Lucent/Coldwater Veneers |
$260.05
|
| Rate for Payer: Lutheran Preferred All Products |
$245.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$309.70
|
| Rate for Payer: PHP All Products |
$259.68
|
| Rate for Payer: Plain Church Group Ministry All Products |
$152.97
|
| Rate for Payer: Signature Care EPO |
$267.75
|
| Rate for Payer: Signature Care PPO |
$267.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$229.00
|
| Rate for Payer: United Healthcare Commercial |
$171.06
|
| Rate for Payer: United Healthcare Medicare |
$206.47
|
|
|
PR INSERT CERVICAL DILATOR
|
Professional
|
$190.46
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
Z12794
|
| Min. Negotiated Rate |
$39.88 |
| Max. Negotiated Rate |
$228.55 |
| Rate for Payer: Aetna Medicare |
$39.88
|
| Rate for Payer: Anthem Exchange |
$106.22
|
| Rate for Payer: Anthem Medicare |
$39.88
|
| Rate for Payer: Anthem PPO |
$106.22
|
| Rate for Payer: Anthem Traditional |
$106.22
|
| Rate for Payer: Caresource Just 4 Me |
$45.86
|
| Rate for Payer: Caresource Medicare |
$43.87
|
| Rate for Payer: Centivo/Paragon All Products |
$61.81
|
| Rate for Payer: Coventry/First Health All Products |
$228.55
|
| Rate for Payer: Frontpath All Products |
$57.79
|
| Rate for Payer: Humana ChoiceCare |
$190.46
|
| Rate for Payer: Humana Medicare |
$39.88
|
| Rate for Payer: Lucent/Coldwater Veneers |
$67.80
|
| Rate for Payer: Lutheran Preferred All Products |
$56.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$142.84
|
| Rate for Payer: PHP All Products |
$51.36
|
| Rate for Payer: Plain Church Group Ministry All Products |
$39.88
|
| Rate for Payer: Signature Care EPO |
$96.05
|
| Rate for Payer: Signature Care PPO |
$96.05
|
| Rate for Payer: Three Rivers Preferred All Products |
$52.00
|
| Rate for Payer: United Healthcare Commercial |
$51.09
|
| Rate for Payer: United Healthcare Medicare |
$95.23
|
|
|
PR INSERT EMERGENCY ENDOTRACH AIRWAY
|
Professional
|
$256.44
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
Z12515
|
| Min. Negotiated Rate |
$128.22 |
| Max. Negotiated Rate |
$307.73 |
| Rate for Payer: Aetna Medicare |
$131.43
|
| Rate for Payer: Anthem Exchange |
$159.50
|
| Rate for Payer: Anthem Medicare |
$131.43
|
| Rate for Payer: Anthem PPO |
$159.50
|
| Rate for Payer: Anthem Traditional |
$159.50
|
| Rate for Payer: Caresource Just 4 Me |
$151.14
|
| Rate for Payer: Caresource Medicare |
$144.57
|
| Rate for Payer: Centivo/Paragon All Products |
$203.72
|
| Rate for Payer: Coventry/First Health All Products |
$307.73
|
| Rate for Payer: Frontpath All Products |
$185.61
|
| Rate for Payer: Humana ChoiceCare |
$256.44
|
| Rate for Payer: Humana Medicare |
$131.43
|
| Rate for Payer: Lucent/Coldwater Veneers |
$223.43
|
| Rate for Payer: Lutheran Preferred All Products |
$210.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$192.33
|
| Rate for Payer: PHP All Products |
$179.51
|
| Rate for Payer: Plain Church Group Ministry All Products |
$131.43
|
| Rate for Payer: Signature Care EPO |
$156.40
|
| Rate for Payer: Signature Care PPO |
$156.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$197.00
|
| Rate for Payer: United Healthcare Commercial |
$128.68
|
| Rate for Payer: United Healthcare Medicare |
$128.22
|
|
|
PR INSERT INTRAUTERINE DEVICE
|
Professional
|
$203.04
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
Z12743
|
| Min. Negotiated Rate |
$61.65 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Anthem Exchange |
$124.82
|
| Rate for Payer: Anthem PPO |
$124.82
|
| Rate for Payer: Anthem Traditional |
$124.82
|
| Rate for Payer: Coventry/First Health All Products |
$243.65
|
| Rate for Payer: Frontpath All Products |
$63.95
|
| Rate for Payer: Humana ChoiceCare |
$203.04
|
| Rate for Payer: Lutheran Preferred All Products |
$67.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$152.28
|
| Rate for Payer: PHP All Products |
$61.65
|
| Rate for Payer: Signature Care EPO |
$117.30
|
| Rate for Payer: Signature Care PPO |
$117.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$62.00
|
| Rate for Payer: United Healthcare Commercial |
$63.26
|
| Rate for Payer: United Healthcare Medicare |
$101.52
|
|
|
PR INSERTION DRUG DELIVERY IMPLANT
|
Professional
|
$182.26
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
Z12035
|
| Min. Negotiated Rate |
$57.90 |
| Max. Negotiated Rate |
$218.71 |
| Rate for Payer: Aetna Medicare |
$57.90
|
| Rate for Payer: Anthem Exchange |
$150.10
|
| Rate for Payer: Anthem Medicare |
$57.90
|
| Rate for Payer: Anthem PPO |
$150.10
|
| Rate for Payer: Anthem Traditional |
$150.10
|
| Rate for Payer: Caresource Just 4 Me |
$66.58
|
| Rate for Payer: Caresource Medicare |
$63.69
|
| Rate for Payer: Centivo/Paragon All Products |
$89.75
|
| Rate for Payer: Coventry/First Health All Products |
$218.71
|
| Rate for Payer: Frontpath All Products |
$83.06
|
| Rate for Payer: Humana ChoiceCare |
$182.26
|
| Rate for Payer: Humana Medicare |
$57.90
|
| Rate for Payer: Lucent/Coldwater Veneers |
$98.43
|
| Rate for Payer: Lutheran Preferred All Products |
$75.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$136.69
|
| Rate for Payer: PHP All Products |
$79.09
|
| Rate for Payer: Plain Church Group Ministry All Products |
$57.90
|
| Rate for Payer: Signature Care EPO |
$132.60
|
| Rate for Payer: Signature Care PPO |
$132.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$69.00
|
| Rate for Payer: United Healthcare Commercial |
$96.04
|
| Rate for Payer: United Healthcare Medicare |
$91.13
|
|
|
PR INSERTION INDWELLING TUNNELED PLEURAL CATHETER
|
Professional
|
$1,438.12
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
Z12519
|
| Min. Negotiated Rate |
$189.07 |
| Max. Negotiated Rate |
$1,725.74 |
| Rate for Payer: Aetna Medicare |
$189.07
|
| Rate for Payer: Anthem Exchange |
$1,165.75
|
| Rate for Payer: Anthem Medicare |
$189.07
|
| Rate for Payer: Anthem PPO |
$1,165.75
|
| Rate for Payer: Anthem Traditional |
$1,165.75
|
| Rate for Payer: Caresource Just 4 Me |
$217.43
|
| Rate for Payer: Caresource Medicare |
$207.98
|
| Rate for Payer: Centivo/Paragon All Products |
$293.06
|
| Rate for Payer: Coventry/First Health All Products |
$1,725.74
|
| Rate for Payer: Frontpath All Products |
$265.77
|
| Rate for Payer: Humana ChoiceCare |
$1,438.12
|
| Rate for Payer: Humana Medicare |
$189.07
|
| Rate for Payer: Lucent/Coldwater Veneers |
$321.42
|
| Rate for Payer: Lutheran Preferred All Products |
$303.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,078.59
|
| Rate for Payer: PHP All Products |
$258.24
|
| Rate for Payer: Plain Church Group Ministry All Products |
$189.07
|
| Rate for Payer: Signature Care EPO |
$981.66
|
| Rate for Payer: Signature Care PPO |
$981.66
|
| Rate for Payer: Three Rivers Preferred All Products |
$284.00
|
| Rate for Payer: United Healthcare Commercial |
$267.21
|
| Rate for Payer: United Healthcare Medicare |
$719.06
|
|
|
PR INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG
|
Professional
|
$7,856.78
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
Z12542
|
| Min. Negotiated Rate |
$79.40 |
| Max. Negotiated Rate |
$9,428.14 |
| Rate for Payer: Aetna Medicare |
$79.40
|
| Rate for Payer: Anthem Exchange |
$4,835.29
|
| Rate for Payer: Anthem Medicare |
$79.40
|
| Rate for Payer: Anthem PPO |
$4,835.29
|
| Rate for Payer: Anthem Traditional |
$4,835.29
|
| Rate for Payer: Caresource Just 4 Me |
$91.31
|
| Rate for Payer: Caresource Medicare |
$87.34
|
| Rate for Payer: Centivo/Paragon All Products |
$123.07
|
| Rate for Payer: Coventry/First Health All Products |
$9,428.14
|
| Rate for Payer: Frontpath All Products |
$114.72
|
| Rate for Payer: Humana ChoiceCare |
$7,856.78
|
| Rate for Payer: Humana Medicare |
$79.40
|
| Rate for Payer: Lucent/Coldwater Veneers |
$134.98
|
| Rate for Payer: Lutheran Preferred All Products |
$127.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$5,892.59
|
| Rate for Payer: PHP All Products |
$108.45
|
| Rate for Payer: Plain Church Group Ministry All Products |
$79.40
|
| Rate for Payer: Signature Care EPO |
$6,822.59
|
| Rate for Payer: Signature Care PPO |
$6,822.59
|
| Rate for Payer: Three Rivers Preferred All Products |
$119.00
|
| Rate for Payer: United Healthcare Commercial |
$107.68
|
| Rate for Payer: United Healthcare Medicare |
$3,928.39
|
|
|
PR INSERT,NON-INDWELLING BLADDER CATHETER
|
Professional
|
$81.04
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
Z12676
|
| Min. Negotiated Rate |
$23.63 |
| Max. Negotiated Rate |
$125.17 |
| Rate for Payer: Aetna Medicare |
$23.63
|
| Rate for Payer: Anthem Exchange |
$125.17
|
| Rate for Payer: Anthem Medicare |
$23.63
|
| Rate for Payer: Anthem PPO |
$125.17
|
| Rate for Payer: Anthem Traditional |
$125.17
|
| Rate for Payer: Caresource Just 4 Me |
$27.17
|
| Rate for Payer: Caresource Medicare |
$25.99
|
| Rate for Payer: Centivo/Paragon All Products |
$36.63
|
| Rate for Payer: Coventry/First Health All Products |
$97.25
|
| Rate for Payer: Frontpath All Products |
$33.83
|
| Rate for Payer: Humana ChoiceCare |
$81.04
|
| Rate for Payer: Humana Medicare |
$23.63
|
| Rate for Payer: Lucent/Coldwater Veneers |
$40.17
|
| Rate for Payer: Lutheran Preferred All Products |
$33.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$60.78
|
| Rate for Payer: PHP All Products |
$42.64
|
| Rate for Payer: Plain Church Group Ministry All Products |
$23.63
|
| Rate for Payer: Signature Care EPO |
$71.32
|
| Rate for Payer: Signature Care PPO |
$71.32
|
| Rate for Payer: Three Rivers Preferred All Products |
$31.00
|
| Rate for Payer: United Healthcare Commercial |
$33.55
|
| Rate for Payer: United Healthcare Medicare |
$40.52
|
|
|
PR INSERT NON-TUNNEL CV CATH
|
Professional
|
$390.08
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
Z12545
|
| Min. Negotiated Rate |
$78.59 |
| Max. Negotiated Rate |
$468.10 |
| Rate for Payer: Aetna Medicare |
$78.59
|
| Rate for Payer: Anthem Exchange |
$358.80
|
| Rate for Payer: Anthem Medicare |
$78.59
|
| Rate for Payer: Anthem PPO |
$358.80
|
| Rate for Payer: Anthem Traditional |
$358.80
|
| Rate for Payer: Caresource Just 4 Me |
$90.38
|
| Rate for Payer: Caresource Medicare |
$86.45
|
| Rate for Payer: Centivo/Paragon All Products |
$121.81
|
| Rate for Payer: Coventry/First Health All Products |
$468.10
|
| Rate for Payer: Frontpath All Products |
$110.10
|
| Rate for Payer: Humana ChoiceCare |
$390.08
|
| Rate for Payer: Humana Medicare |
$78.59
|
| Rate for Payer: Lucent/Coldwater Veneers |
$133.60
|
| Rate for Payer: Lutheran Preferred All Products |
$126.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$292.56
|
| Rate for Payer: PHP All Products |
$130.34
|
| Rate for Payer: Plain Church Group Ministry All Products |
$78.59
|
| Rate for Payer: Signature Care EPO |
$348.82
|
| Rate for Payer: Signature Care PPO |
$348.82
|
| Rate for Payer: Three Rivers Preferred All Products |
$118.00
|
| Rate for Payer: United Healthcare Commercial |
$143.50
|
| Rate for Payer: United Healthcare Medicare |
$195.04
|
|
|
PR INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
$661.44
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
Z12527
|
| Min. Negotiated Rate |
$330.72 |
| Max. Negotiated Rate |
$793.73 |
| Rate for Payer: Caresource Medicare |
$372.89
|
| Rate for Payer: Aetna Medicare |
$338.99
|
| Rate for Payer: Anthem Exchange |
$540.80
|
| Rate for Payer: Anthem Medicare |
$338.99
|
| Rate for Payer: Anthem PPO |
$540.80
|
| Rate for Payer: Anthem Traditional |
$540.80
|
| Rate for Payer: Caresource Just 4 Me |
$389.84
|
| Rate for Payer: Centivo/Paragon All Products |
$525.43
|
| Rate for Payer: Coventry/First Health All Products |
$793.73
|
| Rate for Payer: Frontpath All Products |
$485.55
|
| Rate for Payer: Humana ChoiceCare |
$661.44
|
| Rate for Payer: Humana Medicare |
$338.99
|
| Rate for Payer: Lucent/Coldwater Veneers |
$576.28
|
| Rate for Payer: Lutheran Preferred All Products |
$542.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$496.08
|
| Rate for Payer: PHP All Products |
$463.01
|
| Rate for Payer: Plain Church Group Ministry All Products |
$338.99
|
| Rate for Payer: Signature Care EPO |
$561.00
|
| Rate for Payer: Signature Care PPO |
$561.00
|
| Rate for Payer: Three Rivers Preferred All Products |
$508.00
|
| Rate for Payer: United Healthcare Commercial |
$456.65
|
| Rate for Payer: United Healthcare Medicare |
$330.72
|
|
|
PR INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN
|
Professional
|
$905.42
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
Z12529
|
| Min. Negotiated Rate |
$452.71 |
| Max. Negotiated Rate |
$1,086.50 |
| Rate for Payer: Aetna Medicare |
$464.03
|
| Rate for Payer: Anthem Exchange |
$625.50
|
| Rate for Payer: Anthem Medicare |
$464.03
|
| Rate for Payer: Anthem PPO |
$625.50
|
| Rate for Payer: Anthem Traditional |
$625.50
|
| Rate for Payer: Caresource Just 4 Me |
$533.63
|
| Rate for Payer: Caresource Medicare |
$510.43
|
| Rate for Payer: Centivo/Paragon All Products |
$719.25
|
| Rate for Payer: Coventry/First Health All Products |
$1,086.50
|
| Rate for Payer: Frontpath All Products |
$675.34
|
| Rate for Payer: Humana ChoiceCare |
$905.42
|
| Rate for Payer: Humana Medicare |
$464.03
|
| Rate for Payer: Lucent/Coldwater Veneers |
$788.85
|
| Rate for Payer: Lutheran Preferred All Products |
$742.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$679.06
|
| Rate for Payer: PHP All Products |
$633.80
|
| Rate for Payer: Plain Church Group Ministry All Products |
$464.03
|
| Rate for Payer: Signature Care EPO |
$731.00
|
| Rate for Payer: Signature Care PPO |
$731.00
|
| Rate for Payer: Three Rivers Preferred All Products |
$696.00
|
| Rate for Payer: United Healthcare Commercial |
$617.89
|
| Rate for Payer: United Healthcare Medicare |
$452.71
|
|
|
PR INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN
|
Professional
|
$818.24
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
Z12530
|
| Min. Negotiated Rate |
$313.80 |
| Max. Negotiated Rate |
$981.89 |
| Rate for Payer: Aetna Medicare |
$419.34
|
| Rate for Payer: Anthem Exchange |
$313.80
|
| Rate for Payer: Anthem Medicare |
$419.34
|
| Rate for Payer: Anthem PPO |
$313.80
|
| Rate for Payer: Anthem Traditional |
$313.80
|
| Rate for Payer: Caresource Just 4 Me |
$482.24
|
| Rate for Payer: Caresource Medicare |
$461.27
|
| Rate for Payer: Centivo/Paragon All Products |
$649.98
|
| Rate for Payer: Coventry/First Health All Products |
$981.89
|
| Rate for Payer: Frontpath All Products |
$614.41
|
| Rate for Payer: Humana ChoiceCare |
$818.24
|
| Rate for Payer: Humana Medicare |
$419.34
|
| Rate for Payer: Lucent/Coldwater Veneers |
$712.88
|
| Rate for Payer: Lutheran Preferred All Products |
$671.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$613.68
|
| Rate for Payer: PHP All Products |
$572.76
|
| Rate for Payer: Plain Church Group Ministry All Products |
$419.34
|
| Rate for Payer: Signature Care EPO |
$650.25
|
| Rate for Payer: Signature Care PPO |
$650.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$629.00
|
| Rate for Payer: United Healthcare Commercial |
$557.80
|
| Rate for Payer: United Healthcare Medicare |
$409.12
|
|
|
PR INSJ INTRAPERITONEAL CATHETER W/IMG GUID
|
Professional
|
$1,804.16
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
Z12668
|
| Min. Negotiated Rate |
$187.42 |
| Max. Negotiated Rate |
$2,164.99 |
| Rate for Payer: Aetna Medicare |
$187.42
|
| Rate for Payer: Anthem Exchange |
$1,964.36
|
| Rate for Payer: Anthem Medicare |
$187.42
|
| Rate for Payer: Anthem PPO |
$1,964.36
|
| Rate for Payer: Anthem Traditional |
$1,964.36
|
| Rate for Payer: Caresource Just 4 Me |
$215.53
|
| Rate for Payer: Caresource Medicare |
$206.16
|
| Rate for Payer: Centivo/Paragon All Products |
$290.50
|
| Rate for Payer: Coventry/First Health All Products |
$2,164.99
|
| Rate for Payer: Frontpath All Products |
$259.04
|
| Rate for Payer: Humana ChoiceCare |
$1,804.16
|
| Rate for Payer: Humana Medicare |
$187.42
|
| Rate for Payer: Lucent/Coldwater Veneers |
$318.61
|
| Rate for Payer: Lutheran Preferred All Products |
$281.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,353.12
|
| Rate for Payer: PHP All Products |
$319.99
|
| Rate for Payer: Plain Church Group Ministry All Products |
$187.42
|
| Rate for Payer: Signature Care EPO |
$1,604.83
|
| Rate for Payer: Signature Care PPO |
$1,604.83
|
| Rate for Payer: Three Rivers Preferred All Products |
$262.00
|
| Rate for Payer: United Healthcare Commercial |
$292.49
|
| Rate for Payer: United Healthcare Medicare |
$902.08
|
|
|
PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y
|
Professional
|
$348.60
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
Z12544
|
| Min. Negotiated Rate |
$80.18 |
| Max. Negotiated Rate |
$418.32 |
| Rate for Payer: Caresource Medicare |
$88.20
|
| Rate for Payer: Aetna Medicare |
$80.18
|
| Rate for Payer: Anthem Exchange |
$418.30
|
| Rate for Payer: Anthem Medicare |
$80.18
|
| Rate for Payer: Anthem PPO |
$418.30
|
| Rate for Payer: Anthem Traditional |
$418.30
|
| Rate for Payer: Caresource Just 4 Me |
$92.21
|
| Rate for Payer: Centivo/Paragon All Products |
$124.28
|
| Rate for Payer: Coventry/First Health All Products |
$418.32
|
| Rate for Payer: Frontpath All Products |
$110.80
|
| Rate for Payer: Humana ChoiceCare |
$348.60
|
| Rate for Payer: Humana Medicare |
$80.18
|
| Rate for Payer: Lucent/Coldwater Veneers |
$136.31
|
| Rate for Payer: Lutheran Preferred All Products |
$128.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$261.45
|
| Rate for Payer: PHP All Products |
$132.98
|
| Rate for Payer: Plain Church Group Ministry All Products |
$80.18
|
| Rate for Payer: Signature Care EPO |
$310.93
|
| Rate for Payer: Signature Care PPO |
$310.93
|
| Rate for Payer: Three Rivers Preferred All Products |
$120.00
|
| Rate for Payer: United Healthcare Commercial |
$151.53
|
| Rate for Payer: United Healthcare Medicare |
$174.30
|
|
|
PR INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR
|
Professional
|
$1,618.76
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
Z12537
|
| Min. Negotiated Rate |
$809.38 |
| Max. Negotiated Rate |
$1,942.51 |
| Rate for Payer: Aetna Medicare |
$829.62
|
| Rate for Payer: Anthem Exchange |
$1,354.90
|
| Rate for Payer: Anthem Medicare |
$829.62
|
| Rate for Payer: Anthem PPO |
$1,354.90
|
| Rate for Payer: Anthem Traditional |
$1,354.90
|
| Rate for Payer: Caresource Just 4 Me |
$954.06
|
| Rate for Payer: Caresource Medicare |
$912.58
|
| Rate for Payer: Centivo/Paragon All Products |
$1,285.91
|
| Rate for Payer: Coventry/First Health All Products |
$1,942.51
|
| Rate for Payer: Frontpath All Products |
$1,201.32
|
| Rate for Payer: Humana ChoiceCare |
$1,618.76
|
| Rate for Payer: Humana Medicare |
$829.62
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,410.35
|
| Rate for Payer: Lutheran Preferred All Products |
$1,327.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,214.07
|
| Rate for Payer: PHP All Products |
$1,133.14
|
| Rate for Payer: Plain Church Group Ministry All Products |
$829.62
|
| Rate for Payer: Signature Care EPO |
$1,320.05
|
| Rate for Payer: Signature Care PPO |
$1,320.05
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,244.00
|
| Rate for Payer: United Healthcare Commercial |
$1,098.56
|
| Rate for Payer: United Healthcare Medicare |
$809.38
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
$1,793.60
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
Z12546
|
| Min. Negotiated Rate |
$306.42 |
| Max. Negotiated Rate |
$2,152.32 |
| Rate for Payer: Aetna Medicare |
$306.42
|
| Rate for Payer: Anthem Exchange |
$1,681.40
|
| Rate for Payer: Anthem Medicare |
$306.42
|
| Rate for Payer: Anthem PPO |
$1,681.40
|
| Rate for Payer: Anthem Traditional |
$1,681.40
|
| Rate for Payer: Caresource Just 4 Me |
$352.38
|
| Rate for Payer: Caresource Medicare |
$337.06
|
| Rate for Payer: Centivo/Paragon All Products |
$474.95
|
| Rate for Payer: Coventry/First Health All Products |
$2,152.32
|
| Rate for Payer: Frontpath All Products |
$433.33
|
| Rate for Payer: Humana ChoiceCare |
$1,793.60
|
| Rate for Payer: Humana Medicare |
$306.42
|
| Rate for Payer: Lucent/Coldwater Veneers |
$520.91
|
| Rate for Payer: Lutheran Preferred All Products |
$490.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,345.20
|
| Rate for Payer: PHP All Products |
$508.21
|
| Rate for Payer: Plain Church Group Ministry All Products |
$306.42
|
| Rate for Payer: Signature Care EPO |
$1,632.60
|
| Rate for Payer: Signature Care PPO |
$1,632.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$460.00
|
| Rate for Payer: United Healthcare Commercial |
$403.05
|
| Rate for Payer: United Healthcare Medicare |
$896.80
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PUMP
|
Professional
|
$2,045.22
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
Z12547
|
| Min. Negotiated Rate |
$331.96 |
| Max. Negotiated Rate |
$2,454.26 |
| Rate for Payer: Aetna Medicare |
$331.96
|
| Rate for Payer: Anthem Exchange |
$1,574.90
|
| Rate for Payer: Anthem Medicare |
$331.96
|
| Rate for Payer: Anthem PPO |
$1,574.90
|
| Rate for Payer: Anthem Traditional |
$1,574.90
|
| Rate for Payer: Caresource Just 4 Me |
$381.75
|
| Rate for Payer: Caresource Medicare |
$365.16
|
| Rate for Payer: Centivo/Paragon All Products |
$514.54
|
| Rate for Payer: Coventry/First Health All Products |
$2,454.26
|
| Rate for Payer: Frontpath All Products |
$478.44
|
| Rate for Payer: Humana ChoiceCare |
$2,045.22
|
| Rate for Payer: Humana Medicare |
$331.96
|
| Rate for Payer: Lucent/Coldwater Veneers |
$564.33
|
| Rate for Payer: Lutheran Preferred All Products |
$531.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,533.91
|
| Rate for Payer: PHP All Products |
$550.57
|
| Rate for Payer: Plain Church Group Ministry All Products |
$331.96
|
| Rate for Payer: Signature Care EPO |
$1,624.72
|
| Rate for Payer: Signature Care PPO |
$1,624.72
|
| Rate for Payer: Three Rivers Preferred All Products |
$498.00
|
| Rate for Payer: United Healthcare Commercial |
$418.13
|
| Rate for Payer: United Healthcare Medicare |
$1,022.61
|
|
|
PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT
|
Professional
|
$918.18
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
Z12524
|
| Min. Negotiated Rate |
$459.09 |
| Max. Negotiated Rate |
$1,101.82 |
| Rate for Payer: Aetna Medicare |
$470.57
|
| Rate for Payer: Anthem Exchange |
$814.70
|
| Rate for Payer: Anthem Medicare |
$470.57
|
| Rate for Payer: Anthem PPO |
$814.70
|
| Rate for Payer: Anthem Traditional |
$814.70
|
| Rate for Payer: Caresource Just 4 Me |
$541.16
|
| Rate for Payer: Caresource Medicare |
$517.63
|
| Rate for Payer: Centivo/Paragon All Products |
$729.38
|
| Rate for Payer: Coventry/First Health All Products |
$1,101.82
|
| Rate for Payer: Frontpath All Products |
$680.62
|
| Rate for Payer: Humana ChoiceCare |
$918.18
|
| Rate for Payer: Humana Medicare |
$470.57
|
| Rate for Payer: Lucent/Coldwater Veneers |
$799.97
|
| Rate for Payer: Lutheran Preferred All Products |
$753.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$688.63
|
| Rate for Payer: PHP All Products |
$642.73
|
| Rate for Payer: Plain Church Group Ministry All Products |
$470.57
|
| Rate for Payer: Signature Care EPO |
$757.35
|
| Rate for Payer: Signature Care PPO |
$757.35
|
| Rate for Payer: Three Rivers Preferred All Products |
$706.00
|
| Rate for Payer: United Healthcare Commercial |
$634.64
|
| Rate for Payer: United Healthcare Medicare |
$459.09
|
|
