|
PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Professional
|
$183.02
|
|
|
Service Code
|
CPT 93283
|
| Hospital Charge Code |
Z13096
|
| Min. Negotiated Rate |
$93.80 |
| Max. Negotiated Rate |
$219.62 |
| Rate for Payer: Aetna Medicare |
$93.80
|
| Rate for Payer: Anthem Exchange |
$122.15
|
| Rate for Payer: Anthem Medicare |
$93.80
|
| Rate for Payer: Anthem PPO |
$122.15
|
| Rate for Payer: Anthem Traditional |
$122.15
|
| Rate for Payer: Caresource Just 4 Me |
$107.87
|
| Rate for Payer: Caresource Medicare |
$103.18
|
| Rate for Payer: Centivo/Paragon All Products |
$145.39
|
| Rate for Payer: Coventry/First Health All Products |
$219.62
|
| Rate for Payer: Frontpath All Products |
$107.72
|
| Rate for Payer: Humana ChoiceCare |
$183.02
|
| Rate for Payer: Humana Medicare |
$93.80
|
| Rate for Payer: Lucent/Coldwater Veneers |
$159.46
|
| Rate for Payer: Lutheran Preferred All Products |
$150.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$137.27
|
| Rate for Payer: PHP All Products |
$134.52
|
| Rate for Payer: Plain Church Group Ministry All Products |
$93.80
|
| Rate for Payer: Signature Care EPO |
$125.43
|
| Rate for Payer: Signature Care PPO |
$125.43
|
| Rate for Payer: Three Rivers Preferred All Products |
$141.00
|
| Rate for Payer: United Healthcare Commercial |
$102.48
|
|
|
PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Professional
|
$149.34
|
|
|
Service Code
|
CPT 93282
|
| Hospital Charge Code |
Z13095
|
| Min. Negotiated Rate |
$76.53 |
| Max. Negotiated Rate |
$179.21 |
| Rate for Payer: Aetna Medicare |
$76.53
|
| Rate for Payer: Anthem Exchange |
$100.22
|
| Rate for Payer: Anthem Medicare |
$76.53
|
| Rate for Payer: Anthem PPO |
$100.22
|
| Rate for Payer: Anthem Traditional |
$100.22
|
| Rate for Payer: Caresource Just 4 Me |
$88.01
|
| Rate for Payer: Caresource Medicare |
$84.18
|
| Rate for Payer: Centivo/Paragon All Products |
$118.62
|
| Rate for Payer: Coventry/First Health All Products |
$179.21
|
| Rate for Payer: Frontpath All Products |
$88.31
|
| Rate for Payer: Humana ChoiceCare |
$149.34
|
| Rate for Payer: Humana Medicare |
$76.53
|
| Rate for Payer: Lucent/Coldwater Veneers |
$130.10
|
| Rate for Payer: Lutheran Preferred All Products |
$122.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$112.00
|
| Rate for Payer: PHP All Products |
$109.76
|
| Rate for Payer: Plain Church Group Ministry All Products |
$76.53
|
| Rate for Payer: Signature Care EPO |
$102.92
|
| Rate for Payer: Signature Care PPO |
$102.92
|
| Rate for Payer: Three Rivers Preferred All Products |
$115.00
|
| Rate for Payer: United Healthcare Commercial |
$84.08
|
|
|
PR PROCTOSIGMOIDOSCOPY,RIGID,DIAGNOS
|
Professional
|
$234.36
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
Z12626
|
| Min. Negotiated Rate |
$44.79 |
| Max. Negotiated Rate |
$281.23 |
| Rate for Payer: Aetna Medicare |
$44.79
|
| Rate for Payer: Anthem Exchange |
$111.52
|
| Rate for Payer: Anthem Medicare |
$44.79
|
| Rate for Payer: Anthem PPO |
$111.52
|
| Rate for Payer: Anthem Traditional |
$111.52
|
| Rate for Payer: Caresource Just 4 Me |
$51.51
|
| Rate for Payer: Caresource Medicare |
$49.27
|
| Rate for Payer: Centivo/Paragon All Products |
$69.42
|
| Rate for Payer: Coventry/First Health All Products |
$281.23
|
| Rate for Payer: Frontpath All Products |
$61.53
|
| Rate for Payer: Humana ChoiceCare |
$234.36
|
| Rate for Payer: Humana Medicare |
$44.79
|
| Rate for Payer: Lucent/Coldwater Veneers |
$76.14
|
| Rate for Payer: Lutheran Preferred All Products |
$67.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$175.77
|
| Rate for Payer: PHP All Products |
$76.46
|
| Rate for Payer: Plain Church Group Ministry All Products |
$44.79
|
| Rate for Payer: Signature Care EPO |
$103.93
|
| Rate for Payer: Signature Care PPO |
$103.93
|
| Rate for Payer: Three Rivers Preferred All Products |
$63.00
|
| Rate for Payer: United Healthcare Commercial |
$54.53
|
| Rate for Payer: United Healthcare Medicare |
$117.18
|
|
|
PR PROFES SVC,IMMUNOTHER,SINGLE/MULT AGS
|
Professional
|
$27.18
|
|
|
Service Code
|
CPT 95165
|
| Hospital Charge Code |
Z13136
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$32.62 |
| Rate for Payer: Aetna Medicare |
$3.12
|
| Rate for Payer: Anthem Exchange |
$9.54
|
| Rate for Payer: Anthem Medicare |
$3.12
|
| Rate for Payer: Anthem PPO |
$9.54
|
| Rate for Payer: Anthem Traditional |
$9.54
|
| Rate for Payer: Caresource Just 4 Me |
$3.59
|
| Rate for Payer: Caresource Medicare |
$3.43
|
| Rate for Payer: Centivo/Paragon All Products |
$4.84
|
| Rate for Payer: Coventry/First Health All Products |
$32.62
|
| Rate for Payer: Frontpath All Products |
$3.21
|
| Rate for Payer: Humana ChoiceCare |
$27.18
|
| Rate for Payer: Humana Medicare |
$3.12
|
| Rate for Payer: Lucent/Coldwater Veneers |
$5.30
|
| Rate for Payer: Lutheran Preferred All Products |
$4.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$20.38
|
| Rate for Payer: PHP All Products |
$3.50
|
| Rate for Payer: Plain Church Group Ministry All Products |
$3.12
|
| Rate for Payer: Signature Care EPO |
$12.22
|
| Rate for Payer: Signature Care PPO |
$12.22
|
| Rate for Payer: Three Rivers Preferred All Products |
$4.00
|
| Rate for Payer: United Healthcare Commercial |
$3.80
|
| Rate for Payer: United Healthcare Medicare |
$13.59
|
|
|
PR PROFES SVC, IMMUNOTHER, SUBLINGUAL 3 MON
|
Professional
|
$318.00
|
|
|
Service Code
|
CPT 95165
|
| Hospital Charge Code |
Z13242
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$381.60 |
| Rate for Payer: Aetna Medicare |
$3.12
|
| Rate for Payer: Anthem Exchange |
$9.54
|
| Rate for Payer: Anthem Medicare |
$3.12
|
| Rate for Payer: Anthem PPO |
$9.54
|
| Rate for Payer: Anthem Traditional |
$9.54
|
| Rate for Payer: Caresource Just 4 Me |
$3.59
|
| Rate for Payer: Caresource Medicare |
$3.43
|
| Rate for Payer: Centivo/Paragon All Products |
$4.84
|
| Rate for Payer: Coventry/First Health All Products |
$381.60
|
| Rate for Payer: Frontpath All Products |
$3.21
|
| Rate for Payer: Humana ChoiceCare |
$318.00
|
| Rate for Payer: Humana Medicare |
$3.12
|
| Rate for Payer: Lucent/Coldwater Veneers |
$5.30
|
| Rate for Payer: Lutheran Preferred All Products |
$4.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$238.50
|
| Rate for Payer: PHP All Products |
$3.50
|
| Rate for Payer: Plain Church Group Ministry All Products |
$3.12
|
| Rate for Payer: Signature Care EPO |
$12.22
|
| Rate for Payer: Signature Care PPO |
$12.22
|
| Rate for Payer: Three Rivers Preferred All Products |
$4.00
|
| Rate for Payer: United Healthcare Commercial |
$3.80
|
| Rate for Payer: United Healthcare Medicare |
$13.59
|
|
|
PR PROFES SVC, IMMUNOTHER, SUBLINGUAL 6 MON
|
Professional
|
$399.60
|
|
|
Service Code
|
CPT 95165
|
| Hospital Charge Code |
Z13243
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$479.52 |
| Rate for Payer: Aetna Medicare |
$3.12
|
| Rate for Payer: Anthem Exchange |
$9.54
|
| Rate for Payer: Anthem Medicare |
$3.12
|
| Rate for Payer: Anthem PPO |
$9.54
|
| Rate for Payer: Anthem Traditional |
$9.54
|
| Rate for Payer: Caresource Just 4 Me |
$3.59
|
| Rate for Payer: Caresource Medicare |
$3.43
|
| Rate for Payer: Centivo/Paragon All Products |
$4.84
|
| Rate for Payer: Coventry/First Health All Products |
$479.52
|
| Rate for Payer: Frontpath All Products |
$3.21
|
| Rate for Payer: Humana ChoiceCare |
$399.60
|
| Rate for Payer: Humana Medicare |
$3.12
|
| Rate for Payer: Lucent/Coldwater Veneers |
$5.30
|
| Rate for Payer: Lutheran Preferred All Products |
$4.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$299.70
|
| Rate for Payer: PHP All Products |
$3.50
|
| Rate for Payer: Plain Church Group Ministry All Products |
$3.12
|
| Rate for Payer: Signature Care EPO |
$12.22
|
| Rate for Payer: Signature Care PPO |
$12.22
|
| Rate for Payer: Three Rivers Preferred All Products |
$4.00
|
| Rate for Payer: United Healthcare Commercial |
$3.80
|
| Rate for Payer: United Healthcare Medicare |
$13.59
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER
|
Professional
|
$147.02
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
Z13093
|
| Min. Negotiated Rate |
$75.35 |
| Max. Negotiated Rate |
$176.42 |
| Rate for Payer: Aetna Medicare |
$75.35
|
| Rate for Payer: Anthem Exchange |
$92.81
|
| Rate for Payer: Anthem Medicare |
$75.35
|
| Rate for Payer: Anthem PPO |
$92.81
|
| Rate for Payer: Anthem Traditional |
$92.81
|
| Rate for Payer: Caresource Just 4 Me |
$86.65
|
| Rate for Payer: Caresource Medicare |
$82.89
|
| Rate for Payer: Centivo/Paragon All Products |
$116.79
|
| Rate for Payer: Coventry/First Health All Products |
$176.42
|
| Rate for Payer: Frontpath All Products |
$87.35
|
| Rate for Payer: Humana ChoiceCare |
$147.02
|
| Rate for Payer: Humana Medicare |
$75.35
|
| Rate for Payer: Lucent/Coldwater Veneers |
$128.09
|
| Rate for Payer: Lutheran Preferred All Products |
$121.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$110.27
|
| Rate for Payer: PHP All Products |
$108.07
|
| Rate for Payer: Plain Church Group Ministry All Products |
$75.35
|
| Rate for Payer: Signature Care EPO |
$95.31
|
| Rate for Payer: Signature Care PPO |
$95.31
|
| Rate for Payer: Three Rivers Preferred All Products |
$113.00
|
| Rate for Payer: United Healthcare Commercial |
$77.86
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER
|
Professional
|
$156.56
|
|
|
Service Code
|
CPT 93281
|
| Hospital Charge Code |
Z13094
|
| Min. Negotiated Rate |
$80.24 |
| Max. Negotiated Rate |
$187.87 |
| Rate for Payer: Aetna Medicare |
$80.24
|
| Rate for Payer: Anthem Exchange |
$108.50
|
| Rate for Payer: Anthem Medicare |
$80.24
|
| Rate for Payer: Anthem PPO |
$108.50
|
| Rate for Payer: Anthem Traditional |
$108.50
|
| Rate for Payer: Caresource Just 4 Me |
$92.28
|
| Rate for Payer: Caresource Medicare |
$88.26
|
| Rate for Payer: Centivo/Paragon All Products |
$124.37
|
| Rate for Payer: Coventry/First Health All Products |
$187.87
|
| Rate for Payer: Frontpath All Products |
$92.48
|
| Rate for Payer: Humana ChoiceCare |
$156.56
|
| Rate for Payer: Humana Medicare |
$80.24
|
| Rate for Payer: Lucent/Coldwater Veneers |
$136.41
|
| Rate for Payer: Lutheran Preferred All Products |
$128.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$117.42
|
| Rate for Payer: PHP All Products |
$115.07
|
| Rate for Payer: Plain Church Group Ministry All Products |
$80.24
|
| Rate for Payer: Signature Care EPO |
$111.06
|
| Rate for Payer: Signature Care PPO |
$111.06
|
| Rate for Payer: Three Rivers Preferred All Products |
$120.00
|
| Rate for Payer: United Healthcare Commercial |
$91.03
|
|
|
PR PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES
|
Professional
|
$57.86
|
|
|
Service Code
|
CPT 99417
|
| Hospital Charge Code |
Z13222
|
| Min. Negotiated Rate |
$24.52 |
| Max. Negotiated Rate |
$69.43 |
| Rate for Payer: Anthem Exchange |
$31.52
|
| Rate for Payer: Anthem PPO |
$31.52
|
| Rate for Payer: Anthem Traditional |
$31.52
|
| Rate for Payer: Coventry/First Health All Products |
$69.43
|
| Rate for Payer: Frontpath All Products |
$31.17
|
| Rate for Payer: Humana ChoiceCare |
$57.86
|
| Rate for Payer: Lutheran Preferred All Products |
$30.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$43.39
|
| Rate for Payer: PHP All Products |
$28.86
|
| Rate for Payer: Signature Care EPO |
$24.52
|
| Rate for Payer: Signature Care PPO |
$24.52
|
| Rate for Payer: Three Rivers Preferred All Products |
$30.00
|
| Rate for Payer: United Healthcare Commercial |
$33.62
|
| Rate for Payer: United Healthcare Medicare |
$28.93
|
|
|
PR PROLONGED SVC OUTPATIENT SETTING 1ST HOUR
|
Professional
|
$242.10
|
|
|
Service Code
|
CPT 99354
|
| Hospital Charge Code |
Z13204
|
| Min. Negotiated Rate |
$102.89 |
| Max. Negotiated Rate |
$290.52 |
| Rate for Payer: Anthem Exchange |
$125.90
|
| Rate for Payer: Anthem PPO |
$125.90
|
| Rate for Payer: Anthem Traditional |
$125.90
|
| Rate for Payer: Coventry/First Health All Products |
$290.52
|
| Rate for Payer: Frontpath All Products |
$122.43
|
| Rate for Payer: Humana ChoiceCare |
$242.10
|
| Rate for Payer: Lutheran Preferred All Products |
$205.78
|
| Rate for Payer: PHCS/Multiplan All Products |
$181.57
|
| Rate for Payer: Signature Care EPO |
$102.89
|
| Rate for Payer: Signature Care PPO |
$102.89
|
| Rate for Payer: Three Rivers Preferred All Products |
$145.26
|
|
|
PR PRQ SKEL FIXATION CARP/MTCRPL FX DISLOCATE THUMB
|
Professional
|
$887.50
|
|
|
Service Code
|
CPT 26650
|
| Hospital Charge Code |
Z12283
|
| Min. Negotiated Rate |
$443.75 |
| Max. Negotiated Rate |
$1,065.00 |
| Rate for Payer: Aetna Medicare |
$454.85
|
| Rate for Payer: Anthem Exchange |
$568.00
|
| Rate for Payer: Anthem Medicare |
$454.85
|
| Rate for Payer: Anthem PPO |
$568.00
|
| Rate for Payer: Anthem Traditional |
$568.00
|
| Rate for Payer: Caresource Just 4 Me |
$523.08
|
| Rate for Payer: Caresource Medicare |
$500.34
|
| Rate for Payer: Centivo/Paragon All Products |
$705.02
|
| Rate for Payer: Coventry/First Health All Products |
$1,065.00
|
| Rate for Payer: Frontpath All Products |
$621.04
|
| Rate for Payer: Humana ChoiceCare |
$887.50
|
| Rate for Payer: Humana Medicare |
$454.85
|
| Rate for Payer: Lucent/Coldwater Veneers |
$773.25
|
| Rate for Payer: Lutheran Preferred All Products |
$728.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$665.62
|
| Rate for Payer: PHP All Products |
$772.13
|
| Rate for Payer: Plain Church Group Ministry All Products |
$454.85
|
| Rate for Payer: Signature Care EPO |
$718.25
|
| Rate for Payer: Signature Care PPO |
$718.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$682.00
|
| Rate for Payer: United Healthcare Commercial |
$497.75
|
| Rate for Payer: United Healthcare Medicare |
$443.75
|
|
|
PR PSYCHIATRIC DIAGNOSTIC EVALUATION
|
Professional
|
$330.54
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
Z13017
|
| Min. Negotiated Rate |
$147.48 |
| Max. Negotiated Rate |
$396.65 |
| Rate for Payer: Aetna Medicare |
$147.48
|
| Rate for Payer: Anthem Exchange |
$155.31
|
| Rate for Payer: Anthem Medicare |
$147.48
|
| Rate for Payer: Anthem PPO |
$155.31
|
| Rate for Payer: Anthem Traditional |
$155.31
|
| Rate for Payer: Caresource Just 4 Me |
$169.60
|
| Rate for Payer: Caresource Medicare |
$162.23
|
| Rate for Payer: Centivo/Paragon All Products |
$228.59
|
| Rate for Payer: Coventry/First Health All Products |
$396.65
|
| Rate for Payer: Frontpath All Products |
$168.20
|
| Rate for Payer: Humana ChoiceCare |
$330.54
|
| Rate for Payer: Humana Medicare |
$147.48
|
| Rate for Payer: Lucent/Coldwater Veneers |
$250.72
|
| Rate for Payer: Lutheran Preferred All Products |
$192.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$247.91
|
| Rate for Payer: PHP All Products |
$156.83
|
| Rate for Payer: Plain Church Group Ministry All Products |
$147.48
|
| Rate for Payer: Signature Care EPO |
$166.72
|
| Rate for Payer: Signature Care PPO |
$166.72
|
| Rate for Payer: Three Rivers Preferred All Products |
$177.00
|
| Rate for Payer: United Healthcare Commercial |
$151.14
|
| Rate for Payer: United Healthcare Medicare |
$165.27
|
|
|
PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES
|
Professional
|
$368.66
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
Z13018
|
| Min. Negotiated Rate |
$156.29 |
| Max. Negotiated Rate |
$442.39 |
| Rate for Payer: Aetna Medicare |
$166.71
|
| Rate for Payer: Anthem Exchange |
$165.87
|
| Rate for Payer: Anthem Medicare |
$166.71
|
| Rate for Payer: Anthem PPO |
$165.87
|
| Rate for Payer: Anthem Traditional |
$165.87
|
| Rate for Payer: Caresource Just 4 Me |
$191.72
|
| Rate for Payer: Caresource Medicare |
$183.38
|
| Rate for Payer: Centivo/Paragon All Products |
$258.40
|
| Rate for Payer: Coventry/First Health All Products |
$442.39
|
| Rate for Payer: Frontpath All Products |
$191.50
|
| Rate for Payer: Humana ChoiceCare |
$368.66
|
| Rate for Payer: Humana Medicare |
$166.71
|
| Rate for Payer: Lucent/Coldwater Veneers |
$283.41
|
| Rate for Payer: Lutheran Preferred All Products |
$217.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$276.50
|
| Rate for Payer: PHP All Products |
$177.28
|
| Rate for Payer: Plain Church Group Ministry All Products |
$166.71
|
| Rate for Payer: Signature Care EPO |
$163.34
|
| Rate for Payer: Signature Care PPO |
$163.34
|
| Rate for Payer: Three Rivers Preferred All Products |
$200.00
|
| Rate for Payer: United Healthcare Commercial |
$156.29
|
| Rate for Payer: United Healthcare Medicare |
$184.33
|
|
|
PR PSYCHOANALYSIS
|
Professional
|
$178.68
|
|
|
Service Code
|
CPT 90845
|
| Hospital Charge Code |
Z13027
|
| Min. Negotiated Rate |
$79.70 |
| Max. Negotiated Rate |
$214.42 |
| Rate for Payer: Aetna Medicare |
$81.70
|
| Rate for Payer: Anthem Exchange |
$79.70
|
| Rate for Payer: Anthem Medicare |
$81.70
|
| Rate for Payer: Anthem PPO |
$79.70
|
| Rate for Payer: Anthem Traditional |
$79.70
|
| Rate for Payer: Caresource Just 4 Me |
$93.95
|
| Rate for Payer: Caresource Medicare |
$89.87
|
| Rate for Payer: Centivo/Paragon All Products |
$126.64
|
| Rate for Payer: Coventry/First Health All Products |
$214.42
|
| Rate for Payer: Frontpath All Products |
$94.46
|
| Rate for Payer: Humana ChoiceCare |
$178.68
|
| Rate for Payer: Humana Medicare |
$81.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$138.89
|
| Rate for Payer: Lutheran Preferred All Products |
$106.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$134.01
|
| Rate for Payer: PHP All Products |
$86.88
|
| Rate for Payer: Plain Church Group Ministry All Products |
$81.70
|
| Rate for Payer: Signature Care EPO |
$98.60
|
| Rate for Payer: Signature Care PPO |
$98.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$98.00
|
| Rate for Payer: United Healthcare Commercial |
$97.93
|
| Rate for Payer: United Healthcare Medicare |
$89.34
|
|
|
PR PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Professional
|
$28.16
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
Z13016
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$33.79 |
| Rate for Payer: Aetna Medicare |
$12.89
|
| Rate for Payer: Anthem Exchange |
$4.77
|
| Rate for Payer: Anthem Medicare |
$12.89
|
| Rate for Payer: Anthem PPO |
$4.77
|
| Rate for Payer: Anthem Traditional |
$4.77
|
| Rate for Payer: Caresource Just 4 Me |
$14.82
|
| Rate for Payer: Caresource Medicare |
$14.18
|
| Rate for Payer: Centivo/Paragon All Products |
$19.98
|
| Rate for Payer: Coventry/First Health All Products |
$33.79
|
| Rate for Payer: Frontpath All Products |
$14.37
|
| Rate for Payer: Humana ChoiceCare |
$28.16
|
| Rate for Payer: Humana Medicare |
$12.89
|
| Rate for Payer: Lucent/Coldwater Veneers |
$21.91
|
| Rate for Payer: Lutheran Preferred All Products |
$17.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$21.12
|
| Rate for Payer: PHP All Products |
$13.70
|
| Rate for Payer: Plain Church Group Ministry All Products |
$12.89
|
| Rate for Payer: Signature Care EPO |
$12.22
|
| Rate for Payer: Signature Care PPO |
$12.22
|
| Rate for Payer: Three Rivers Preferred All Products |
$15.00
|
| Rate for Payer: United Healthcare Commercial |
$6.06
|
| Rate for Payer: United Healthcare Medicare |
$14.08
|
|
|
PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES
|
Professional
|
$131.22
|
|
|
Service Code
|
CPT 90840
|
| Hospital Charge Code |
Z13026
|
| Min. Negotiated Rate |
$58.07 |
| Max. Negotiated Rate |
$157.46 |
| Rate for Payer: Aetna Medicare |
$60.45
|
| Rate for Payer: Anthem Exchange |
$64.98
|
| Rate for Payer: Anthem Medicare |
$60.45
|
| Rate for Payer: Anthem PPO |
$64.98
|
| Rate for Payer: Anthem Traditional |
$64.98
|
| Rate for Payer: Caresource Just 4 Me |
$69.52
|
| Rate for Payer: Caresource Medicare |
$66.50
|
| Rate for Payer: Centivo/Paragon All Products |
$93.70
|
| Rate for Payer: Coventry/First Health All Products |
$157.46
|
| Rate for Payer: Frontpath All Products |
$70.37
|
| Rate for Payer: Humana ChoiceCare |
$131.22
|
| Rate for Payer: Humana Medicare |
$60.45
|
| Rate for Payer: Lucent/Coldwater Veneers |
$102.77
|
| Rate for Payer: Lutheran Preferred All Products |
$79.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$98.41
|
| Rate for Payer: PHP All Products |
$64.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$60.45
|
| Rate for Payer: Signature Care EPO |
$58.07
|
| Rate for Payer: Signature Care PPO |
$58.07
|
| Rate for Payer: Three Rivers Preferred All Products |
$73.00
|
| Rate for Payer: United Healthcare Commercial |
$114.65
|
| Rate for Payer: United Healthcare Medicare |
$65.61
|
|
|
PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES
|
Professional
|
$266.72
|
|
|
Service Code
|
CPT 90839
|
| Hospital Charge Code |
Z13025
|
| Min. Negotiated Rate |
$121.88 |
| Max. Negotiated Rate |
$320.06 |
| Rate for Payer: Aetna Medicare |
$121.88
|
| Rate for Payer: Anthem Exchange |
$129.95
|
| Rate for Payer: Anthem Medicare |
$121.88
|
| Rate for Payer: Anthem PPO |
$129.95
|
| Rate for Payer: Anthem Traditional |
$129.95
|
| Rate for Payer: Caresource Just 4 Me |
$140.16
|
| Rate for Payer: Caresource Medicare |
$134.07
|
| Rate for Payer: Centivo/Paragon All Products |
$188.91
|
| Rate for Payer: Coventry/First Health All Products |
$320.06
|
| Rate for Payer: Frontpath All Products |
$139.44
|
| Rate for Payer: Humana ChoiceCare |
$266.72
|
| Rate for Payer: Humana Medicare |
$121.88
|
| Rate for Payer: Lucent/Coldwater Veneers |
$207.20
|
| Rate for Payer: Lutheran Preferred All Products |
$158.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$200.04
|
| Rate for Payer: PHP All Products |
$129.61
|
| Rate for Payer: Plain Church Group Ministry All Products |
$121.88
|
| Rate for Payer: Signature Care EPO |
$151.11
|
| Rate for Payer: Signature Care PPO |
$151.11
|
| Rate for Payer: Three Rivers Preferred All Products |
$146.00
|
| Rate for Payer: United Healthcare Commercial |
$221.39
|
| Rate for Payer: United Healthcare Medicare |
$133.36
|
|
|
PR PSYCHOTHERAPY W/PATIENT 30 MINUTES
|
Professional
|
$143.18
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
Z13019
|
| Min. Negotiated Rate |
$63.50 |
| Max. Negotiated Rate |
$171.82 |
| Rate for Payer: Aetna Medicare |
$65.04
|
| Rate for Payer: Anthem Exchange |
$65.72
|
| Rate for Payer: Anthem Medicare |
$65.04
|
| Rate for Payer: Anthem PPO |
$65.72
|
| Rate for Payer: Anthem Traditional |
$65.72
|
| Rate for Payer: Caresource Just 4 Me |
$74.80
|
| Rate for Payer: Caresource Medicare |
$71.54
|
| Rate for Payer: Centivo/Paragon All Products |
$100.81
|
| Rate for Payer: Coventry/First Health All Products |
$171.82
|
| Rate for Payer: Frontpath All Products |
$75.27
|
| Rate for Payer: Humana ChoiceCare |
$143.18
|
| Rate for Payer: Humana Medicare |
$65.04
|
| Rate for Payer: Lucent/Coldwater Veneers |
$110.57
|
| Rate for Payer: Lutheran Preferred All Products |
$85.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$107.39
|
| Rate for Payer: PHP All Products |
$69.17
|
| Rate for Payer: Plain Church Group Ministry All Products |
$65.04
|
| Rate for Payer: Signature Care EPO |
$69.45
|
| Rate for Payer: Signature Care PPO |
$69.45
|
| Rate for Payer: Three Rivers Preferred All Products |
$78.00
|
| Rate for Payer: United Healthcare Commercial |
$63.50
|
| Rate for Payer: United Healthcare Medicare |
$71.59
|
|
|
PR PSYCHOTHERAPY W/PATIENT 45 MINUTES
|
Professional
|
$189.16
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
Z13021
|
| Min. Negotiated Rate |
$86.13 |
| Max. Negotiated Rate |
$226.99 |
| Rate for Payer: Aetna Medicare |
$86.13
|
| Rate for Payer: Anthem Exchange |
$90.84
|
| Rate for Payer: Anthem Medicare |
$86.13
|
| Rate for Payer: Anthem PPO |
$90.84
|
| Rate for Payer: Anthem Traditional |
$90.84
|
| Rate for Payer: Caresource Just 4 Me |
$99.05
|
| Rate for Payer: Caresource Medicare |
$94.74
|
| Rate for Payer: Centivo/Paragon All Products |
$133.50
|
| Rate for Payer: Coventry/First Health All Products |
$226.99
|
| Rate for Payer: Frontpath All Products |
$99.10
|
| Rate for Payer: Humana ChoiceCare |
$189.16
|
| Rate for Payer: Humana Medicare |
$86.13
|
| Rate for Payer: Lucent/Coldwater Veneers |
$146.42
|
| Rate for Payer: Lutheran Preferred All Products |
$112.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$141.87
|
| Rate for Payer: PHP All Products |
$91.60
|
| Rate for Payer: Plain Church Group Ministry All Products |
$86.13
|
| Rate for Payer: Signature Care EPO |
$90.24
|
| Rate for Payer: Signature Care PPO |
$90.24
|
| Rate for Payer: Three Rivers Preferred All Products |
$103.00
|
| Rate for Payer: United Healthcare Commercial |
$95.38
|
| Rate for Payer: United Healthcare Medicare |
$94.58
|
|
|
PR PSYCHOTHERAPY W/PATIENT 60 MINUTES
|
Professional
|
$278.60
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
Z13023
|
| Min. Negotiated Rate |
$126.73 |
| Max. Negotiated Rate |
$334.32 |
| Rate for Payer: Aetna Medicare |
$126.73
|
| Rate for Payer: Anthem Exchange |
$133.86
|
| Rate for Payer: Anthem Medicare |
$126.73
|
| Rate for Payer: Anthem PPO |
$133.86
|
| Rate for Payer: Anthem Traditional |
$133.86
|
| Rate for Payer: Caresource Just 4 Me |
$145.74
|
| Rate for Payer: Caresource Medicare |
$139.40
|
| Rate for Payer: Centivo/Paragon All Products |
$196.43
|
| Rate for Payer: Coventry/First Health All Products |
$334.32
|
| Rate for Payer: Frontpath All Products |
$145.18
|
| Rate for Payer: Humana ChoiceCare |
$278.60
|
| Rate for Payer: Humana Medicare |
$126.73
|
| Rate for Payer: Lucent/Coldwater Veneers |
$215.44
|
| Rate for Payer: Lutheran Preferred All Products |
$165.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$208.95
|
| Rate for Payer: PHP All Products |
$134.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$126.73
|
| Rate for Payer: Signature Care EPO |
$132.22
|
| Rate for Payer: Signature Care PPO |
$132.22
|
| Rate for Payer: Three Rivers Preferred All Products |
$152.00
|
| Rate for Payer: United Healthcare Commercial |
$143.80
|
| Rate for Payer: United Healthcare Medicare |
$139.30
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN
|
Professional
|
$130.58
|
|
|
Service Code
|
CPT 90833
|
| Hospital Charge Code |
Z13020
|
| Min. Negotiated Rate |
$24.73 |
| Max. Negotiated Rate |
$156.70 |
| Rate for Payer: Aetna Medicare |
$60.13
|
| Rate for Payer: Anthem Exchange |
$24.73
|
| Rate for Payer: Anthem Medicare |
$60.13
|
| Rate for Payer: Anthem PPO |
$24.73
|
| Rate for Payer: Anthem Traditional |
$24.73
|
| Rate for Payer: Caresource Just 4 Me |
$69.15
|
| Rate for Payer: Caresource Medicare |
$66.14
|
| Rate for Payer: Centivo/Paragon All Products |
$93.20
|
| Rate for Payer: Coventry/First Health All Products |
$156.70
|
| Rate for Payer: Frontpath All Products |
$69.40
|
| Rate for Payer: Humana ChoiceCare |
$130.58
|
| Rate for Payer: Humana Medicare |
$60.13
|
| Rate for Payer: Lucent/Coldwater Veneers |
$102.22
|
| Rate for Payer: Lutheran Preferred All Products |
$78.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$97.94
|
| Rate for Payer: PHP All Products |
$63.95
|
| Rate for Payer: Plain Church Group Ministry All Products |
$60.13
|
| Rate for Payer: Signature Care EPO |
$58.06
|
| Rate for Payer: Signature Care PPO |
$58.06
|
| Rate for Payer: Three Rivers Preferred All Products |
$72.00
|
| Rate for Payer: United Healthcare Commercial |
$53.13
|
| Rate for Payer: United Healthcare Medicare |
$65.29
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN
|
Professional
|
$165.48
|
|
|
Service Code
|
CPT 90836
|
| Hospital Charge Code |
Z13022
|
| Min. Negotiated Rate |
$27.89 |
| Max. Negotiated Rate |
$198.58 |
| Rate for Payer: Aetna Medicare |
$76.17
|
| Rate for Payer: Anthem Exchange |
$27.89
|
| Rate for Payer: Anthem Medicare |
$76.17
|
| Rate for Payer: Anthem PPO |
$27.89
|
| Rate for Payer: Anthem Traditional |
$27.89
|
| Rate for Payer: Caresource Just 4 Me |
$87.60
|
| Rate for Payer: Caresource Medicare |
$83.79
|
| Rate for Payer: Centivo/Paragon All Products |
$118.06
|
| Rate for Payer: Coventry/First Health All Products |
$198.58
|
| Rate for Payer: Frontpath All Products |
$87.47
|
| Rate for Payer: Humana ChoiceCare |
$165.48
|
| Rate for Payer: Humana Medicare |
$76.17
|
| Rate for Payer: Lucent/Coldwater Veneers |
$129.49
|
| Rate for Payer: Lutheran Preferred All Products |
$99.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$124.11
|
| Rate for Payer: PHP All Products |
$81.00
|
| Rate for Payer: Plain Church Group Ministry All Products |
$76.17
|
| Rate for Payer: Signature Care EPO |
$75.44
|
| Rate for Payer: Signature Care PPO |
$75.44
|
| Rate for Payer: Three Rivers Preferred All Products |
$91.00
|
| Rate for Payer: United Healthcare Commercial |
$87.00
|
| Rate for Payer: United Healthcare Medicare |
$82.74
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN
|
Professional
|
$218.76
|
|
|
Service Code
|
CPT 90838
|
| Hospital Charge Code |
Z13024
|
| Min. Negotiated Rate |
$41.37 |
| Max. Negotiated Rate |
$262.51 |
| Rate for Payer: Caresource Just 4 Me |
$116.15
|
| Rate for Payer: Aetna Medicare |
$101.00
|
| Rate for Payer: Anthem Exchange |
$41.37
|
| Rate for Payer: Anthem Medicare |
$101.00
|
| Rate for Payer: Anthem PPO |
$41.37
|
| Rate for Payer: Anthem Traditional |
$41.37
|
| Rate for Payer: Caresource Medicare |
$111.10
|
| Rate for Payer: Centivo/Paragon All Products |
$156.55
|
| Rate for Payer: Coventry/First Health All Products |
$262.51
|
| Rate for Payer: Frontpath All Products |
$115.67
|
| Rate for Payer: Humana ChoiceCare |
$218.76
|
| Rate for Payer: Humana Medicare |
$101.00
|
| Rate for Payer: Lucent/Coldwater Veneers |
$171.70
|
| Rate for Payer: Lutheran Preferred All Products |
$131.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$164.07
|
| Rate for Payer: PHP All Products |
$107.40
|
| Rate for Payer: Plain Church Group Ministry All Products |
$101.00
|
| Rate for Payer: Signature Care EPO |
$121.80
|
| Rate for Payer: Signature Care PPO |
$121.80
|
| Rate for Payer: Three Rivers Preferred All Products |
$121.00
|
| Rate for Payer: United Healthcare Commercial |
$139.64
|
| Rate for Payer: United Healthcare Medicare |
$109.38
|
|
|
PR PUCT/ASPIR BREAST CYST,EACH ADDN
|
Professional
|
$48.30
|
|
|
Service Code
|
CPT 19001
|
| Hospital Charge Code |
Z12101
|
| Min. Negotiated Rate |
$19.51 |
| Max. Negotiated Rate |
$57.96 |
| Rate for Payer: Aetna Medicare |
$19.51
|
| Rate for Payer: Anthem Exchange |
$36.93
|
| Rate for Payer: Anthem Medicare |
$19.51
|
| Rate for Payer: Anthem PPO |
$36.93
|
| Rate for Payer: Anthem Traditional |
$36.93
|
| Rate for Payer: Caresource Just 4 Me |
$22.44
|
| Rate for Payer: Caresource Medicare |
$21.46
|
| Rate for Payer: Centivo/Paragon All Products |
$30.24
|
| Rate for Payer: Coventry/First Health All Products |
$57.96
|
| Rate for Payer: Frontpath All Products |
$27.52
|
| Rate for Payer: Humana ChoiceCare |
$48.30
|
| Rate for Payer: Humana Medicare |
$19.51
|
| Rate for Payer: Lucent/Coldwater Veneers |
$33.17
|
| Rate for Payer: Lutheran Preferred All Products |
$25.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$36.22
|
| Rate for Payer: PHP All Products |
$26.64
|
| Rate for Payer: Plain Church Group Ministry All Products |
$19.51
|
| Rate for Payer: Signature Care EPO |
$43.03
|
| Rate for Payer: Signature Care PPO |
$43.03
|
| Rate for Payer: Three Rivers Preferred All Products |
$23.00
|
| Rate for Payer: United Healthcare Commercial |
$26.23
|
| Rate for Payer: United Healthcare Medicare |
$24.15
|
|
|
PR PUNC/ASPIR BREAST CYST
|
Professional
|
$186.10
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
Z12100
|
| Min. Negotiated Rate |
$39.81 |
| Max. Negotiated Rate |
$223.32 |
| Rate for Payer: Aetna Medicare |
$39.81
|
| Rate for Payer: Anthem Exchange |
$143.88
|
| Rate for Payer: Anthem Medicare |
$39.81
|
| Rate for Payer: Anthem PPO |
$143.88
|
| Rate for Payer: Anthem Traditional |
$143.88
|
| Rate for Payer: Caresource Just 4 Me |
$45.78
|
| Rate for Payer: Caresource Medicare |
$43.79
|
| Rate for Payer: Centivo/Paragon All Products |
$61.71
|
| Rate for Payer: Coventry/First Health All Products |
$223.32
|
| Rate for Payer: Frontpath All Products |
$55.44
|
| Rate for Payer: Humana ChoiceCare |
$186.10
|
| Rate for Payer: Humana Medicare |
$39.81
|
| Rate for Payer: Lucent/Coldwater Veneers |
$67.68
|
| Rate for Payer: Lutheran Preferred All Products |
$52.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$139.57
|
| Rate for Payer: PHP All Products |
$54.37
|
| Rate for Payer: Plain Church Group Ministry All Products |
$39.81
|
| Rate for Payer: Signature Care EPO |
$114.75
|
| Rate for Payer: Signature Care PPO |
$114.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$48.00
|
| Rate for Payer: United Healthcare Commercial |
$52.45
|
| Rate for Payer: United Healthcare Medicare |
$93.05
|
|
