|
PR SURG RX MISSED ABORTN,1ST TRI
|
Professional
|
$788.72
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
Z12815
|
| Min. Negotiated Rate |
$353.59 |
| Max. Negotiated Rate |
$946.46 |
| Rate for Payer: Aetna Medicare |
$353.59
|
| Rate for Payer: Anthem Exchange |
$459.14
|
| Rate for Payer: Anthem Medicare |
$353.59
|
| Rate for Payer: Anthem PPO |
$459.14
|
| Rate for Payer: Anthem Traditional |
$459.14
|
| Rate for Payer: Caresource Just 4 Me |
$406.63
|
| Rate for Payer: Caresource Medicare |
$388.95
|
| Rate for Payer: Centivo/Paragon All Products |
$548.06
|
| Rate for Payer: Coventry/First Health All Products |
$946.46
|
| Rate for Payer: Frontpath All Products |
$494.80
|
| Rate for Payer: Humana ChoiceCare |
$788.72
|
| Rate for Payer: Humana Medicare |
$353.59
|
| Rate for Payer: Lucent/Coldwater Veneers |
$601.10
|
| Rate for Payer: Lutheran Preferred All Products |
$495.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$591.54
|
| Rate for Payer: PHP All Products |
$455.35
|
| Rate for Payer: Plain Church Group Ministry All Products |
$353.59
|
| Rate for Payer: Signature Care EPO |
$371.45
|
| Rate for Payer: Signature Care PPO |
$371.45
|
| Rate for Payer: Three Rivers Preferred All Products |
$460.00
|
| Rate for Payer: United Healthcare Commercial |
$382.33
|
| Rate for Payer: United Healthcare Medicare |
$394.36
|
|
|
PR SURG RX MISSED ABORTN,2ND TRI
|
Professional
|
$776.46
|
|
|
Service Code
|
CPT 59821
|
| Hospital Charge Code |
Z12816
|
| Min. Negotiated Rate |
$344.99 |
| Max. Negotiated Rate |
$931.75 |
| Rate for Payer: Aetna Medicare |
$344.99
|
| Rate for Payer: Anthem Exchange |
$479.70
|
| Rate for Payer: Anthem Medicare |
$344.99
|
| Rate for Payer: Anthem PPO |
$479.70
|
| Rate for Payer: Anthem Traditional |
$479.70
|
| Rate for Payer: Caresource Just 4 Me |
$396.74
|
| Rate for Payer: Caresource Medicare |
$379.49
|
| Rate for Payer: Centivo/Paragon All Products |
$534.73
|
| Rate for Payer: Coventry/First Health All Products |
$931.75
|
| Rate for Payer: Frontpath All Products |
$486.37
|
| Rate for Payer: Humana ChoiceCare |
$776.46
|
| Rate for Payer: Humana Medicare |
$344.99
|
| Rate for Payer: Lucent/Coldwater Veneers |
$586.48
|
| Rate for Payer: Lutheran Preferred All Products |
$483.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$582.35
|
| Rate for Payer: PHP All Products |
$444.48
|
| Rate for Payer: Plain Church Group Ministry All Products |
$344.99
|
| Rate for Payer: Signature Care EPO |
$392.70
|
| Rate for Payer: Signature Care PPO |
$392.70
|
| Rate for Payer: Three Rivers Preferred All Products |
$448.00
|
| Rate for Payer: United Healthcare Commercial |
$388.44
|
| Rate for Payer: United Healthcare Medicare |
$388.23
|
|
|
PR SUSPENSION OF VAGINA,ABD APPRCH
|
Professional
|
$1,765.42
|
|
|
Service Code
|
CPT 57280
|
| Hospital Charge Code |
Z12710
|
| Min. Negotiated Rate |
$882.71 |
| Max. Negotiated Rate |
$2,118.50 |
| Rate for Payer: Aetna Medicare |
$904.78
|
| Rate for Payer: Anthem Exchange |
$1,178.20
|
| Rate for Payer: Anthem Medicare |
$904.78
|
| Rate for Payer: Anthem PPO |
$1,178.20
|
| Rate for Payer: Anthem Traditional |
$1,178.20
|
| Rate for Payer: Caresource Just 4 Me |
$1,040.50
|
| Rate for Payer: Caresource Medicare |
$995.26
|
| Rate for Payer: Centivo/Paragon All Products |
$1,402.41
|
| Rate for Payer: Coventry/First Health All Products |
$2,118.50
|
| Rate for Payer: Frontpath All Products |
$1,266.34
|
| Rate for Payer: Humana ChoiceCare |
$1,765.42
|
| Rate for Payer: Humana Medicare |
$904.78
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,538.13
|
| Rate for Payer: Lutheran Preferred All Products |
$1,267.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,324.07
|
| Rate for Payer: PHP All Products |
$1,165.18
|
| Rate for Payer: Plain Church Group Ministry All Products |
$904.78
|
| Rate for Payer: Signature Care EPO |
$1,120.30
|
| Rate for Payer: Signature Care PPO |
$1,120.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,176.00
|
| Rate for Payer: United Healthcare Commercial |
$1,095.11
|
| Rate for Payer: United Healthcare Medicare |
$882.71
|
|
|
PR SUTURE LRG INTEST
|
Professional
|
$1,879.84
|
|
|
Service Code
|
CPT 44604
|
| Hospital Charge Code |
Z12617
|
| Min. Negotiated Rate |
$939.92 |
| Max. Negotiated Rate |
$2,255.81 |
| Rate for Payer: Aetna Medicare |
$963.42
|
| Rate for Payer: Anthem Exchange |
$1,094.20
|
| Rate for Payer: Anthem Medicare |
$963.42
|
| Rate for Payer: Anthem PPO |
$1,094.20
|
| Rate for Payer: Anthem Traditional |
$1,094.20
|
| Rate for Payer: Caresource Just 4 Me |
$1,107.93
|
| Rate for Payer: Caresource Medicare |
$1,059.76
|
| Rate for Payer: Centivo/Paragon All Products |
$1,493.30
|
| Rate for Payer: Coventry/First Health All Products |
$2,255.81
|
| Rate for Payer: Frontpath All Products |
$1,390.99
|
| Rate for Payer: Humana ChoiceCare |
$1,879.84
|
| Rate for Payer: Humana Medicare |
$963.42
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,637.81
|
| Rate for Payer: Lutheran Preferred All Products |
$1,445.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,409.88
|
| Rate for Payer: PHP All Products |
$1,644.86
|
| Rate for Payer: Plain Church Group Ministry All Products |
$963.42
|
| Rate for Payer: Signature Care EPO |
$1,301.35
|
| Rate for Payer: Signature Care PPO |
$1,301.35
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,349.00
|
| Rate for Payer: United Healthcare Commercial |
$1,135.91
|
| Rate for Payer: United Healthcare Medicare |
$939.92
|
|
|
PR SUTURE OF MESENTERY
|
Professional
|
$1,334.44
|
|
|
Service Code
|
CPT 44850
|
| Hospital Charge Code |
Z12622
|
| Min. Negotiated Rate |
$667.22 |
| Max. Negotiated Rate |
$1,601.33 |
| Rate for Payer: Aetna Medicare |
$683.90
|
| Rate for Payer: Anthem Exchange |
$754.20
|
| Rate for Payer: Anthem Medicare |
$683.90
|
| Rate for Payer: Anthem PPO |
$754.20
|
| Rate for Payer: Anthem Traditional |
$754.20
|
| Rate for Payer: Caresource Just 4 Me |
$786.48
|
| Rate for Payer: Caresource Medicare |
$752.29
|
| Rate for Payer: Centivo/Paragon All Products |
$1,060.05
|
| Rate for Payer: Coventry/First Health All Products |
$1,601.33
|
| Rate for Payer: Frontpath All Products |
$990.66
|
| Rate for Payer: Humana ChoiceCare |
$1,334.44
|
| Rate for Payer: Humana Medicare |
$683.90
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,162.63
|
| Rate for Payer: Lutheran Preferred All Products |
$1,026.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,000.83
|
| Rate for Payer: PHP All Products |
$1,167.64
|
| Rate for Payer: Plain Church Group Ministry All Products |
$683.90
|
| Rate for Payer: Signature Care EPO |
$908.65
|
| Rate for Payer: Signature Care PPO |
$908.65
|
| Rate for Payer: Three Rivers Preferred All Products |
$957.00
|
| Rate for Payer: United Healthcare Commercial |
$789.30
|
| Rate for Payer: United Healthcare Medicare |
$667.22
|
|
|
PR SUTURE SM INTEST,SINGLE PERF
|
Professional
|
$2,500.08
|
|
|
Service Code
|
CPT 44602
|
| Hospital Charge Code |
Z12616
|
| Min. Negotiated Rate |
$868.60 |
| Max. Negotiated Rate |
$3,000.10 |
| Rate for Payer: Aetna Medicare |
$1,281.29
|
| Rate for Payer: Anthem Exchange |
$868.60
|
| Rate for Payer: Anthem Medicare |
$1,281.29
|
| Rate for Payer: Anthem PPO |
$868.60
|
| Rate for Payer: Anthem Traditional |
$868.60
|
| Rate for Payer: Caresource Just 4 Me |
$1,473.48
|
| Rate for Payer: Caresource Medicare |
$1,409.42
|
| Rate for Payer: Centivo/Paragon All Products |
$1,986.00
|
| Rate for Payer: Coventry/First Health All Products |
$3,000.10
|
| Rate for Payer: Frontpath All Products |
$1,863.10
|
| Rate for Payer: Humana ChoiceCare |
$2,500.08
|
| Rate for Payer: Humana Medicare |
$1,281.29
|
| Rate for Payer: Lucent/Coldwater Veneers |
$2,178.19
|
| Rate for Payer: Lutheran Preferred All Products |
$1,922.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,875.06
|
| Rate for Payer: PHP All Products |
$2,187.57
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,281.29
|
| Rate for Payer: Signature Care EPO |
$1,286.90
|
| Rate for Payer: Signature Care PPO |
$1,286.90
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,794.00
|
| Rate for Payer: United Healthcare Commercial |
$1,480.99
|
| Rate for Payer: United Healthcare Medicare |
$1,250.04
|
|
|
PR SYNTHETIC SENTENCE TEST
|
Professional
|
$71.40
|
|
|
Service Code
|
CPT 92576
|
| Hospital Charge Code |
Z13055
|
| Min. Negotiated Rate |
$17.90 |
| Max. Negotiated Rate |
$85.68 |
| Rate for Payer: Aetna Medicare |
$36.59
|
| Rate for Payer: Anthem Exchange |
$17.90
|
| Rate for Payer: Anthem Medicare |
$36.59
|
| Rate for Payer: Anthem PPO |
$17.90
|
| Rate for Payer: Anthem Traditional |
$17.90
|
| Rate for Payer: Caresource Just 4 Me |
$42.08
|
| Rate for Payer: Caresource Medicare |
$40.25
|
| Rate for Payer: Centivo/Paragon All Products |
$56.71
|
| Rate for Payer: Coventry/First Health All Products |
$85.68
|
| Rate for Payer: Frontpath All Products |
$39.00
|
| Rate for Payer: Humana ChoiceCare |
$71.40
|
| Rate for Payer: Humana Medicare |
$36.59
|
| Rate for Payer: Lucent/Coldwater Veneers |
$62.20
|
| Rate for Payer: Lutheran Preferred All Products |
$48.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$53.55
|
| Rate for Payer: PHP All Products |
$51.76
|
| Rate for Payer: Plain Church Group Ministry All Products |
$36.59
|
| Rate for Payer: Signature Care EPO |
$29.52
|
| Rate for Payer: Signature Care PPO |
$29.52
|
| Rate for Payer: Three Rivers Preferred All Products |
$44.00
|
| Rate for Payer: United Healthcare Commercial |
$23.29
|
| Rate for Payer: United Healthcare Medicare |
$35.70
|
|
|
PR TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
$92.04
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
Z11974
|
| Min. Negotiated Rate |
$20.31 |
| Max. Negotiated Rate |
$110.45 |
| Rate for Payer: Aetna Medicare |
$20.31
|
| Rate for Payer: Anthem Exchange |
$50.15
|
| Rate for Payer: Anthem Medicare |
$20.31
|
| Rate for Payer: Anthem PPO |
$50.15
|
| Rate for Payer: Anthem Traditional |
$50.15
|
| Rate for Payer: Caresource Just 4 Me |
$23.36
|
| Rate for Payer: Caresource Medicare |
$22.34
|
| Rate for Payer: Centivo/Paragon All Products |
$31.48
|
| Rate for Payer: Coventry/First Health All Products |
$110.45
|
| Rate for Payer: Frontpath All Products |
$28.11
|
| Rate for Payer: Humana ChoiceCare |
$92.04
|
| Rate for Payer: Humana Medicare |
$20.31
|
| Rate for Payer: Lucent/Coldwater Veneers |
$34.53
|
| Rate for Payer: Lutheran Preferred All Products |
$26.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$69.03
|
| Rate for Payer: PHP All Products |
$27.74
|
| Rate for Payer: Plain Church Group Ministry All Products |
$20.31
|
| Rate for Payer: Signature Care EPO |
$50.30
|
| Rate for Payer: Signature Care PPO |
$50.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$24.00
|
| Rate for Payer: United Healthcare Commercial |
$28.00
|
| Rate for Payer: United Healthcare Medicare |
$46.02
|
|
|
PR TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Professional
|
$185.58
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
Z11973
|
| Min. Negotiated Rate |
$35.53 |
| Max. Negotiated Rate |
$222.70 |
| Rate for Payer: Aetna Medicare |
$35.53
|
| Rate for Payer: Anthem Exchange |
$92.91
|
| Rate for Payer: Anthem Medicare |
$35.53
|
| Rate for Payer: Anthem PPO |
$92.91
|
| Rate for Payer: Anthem Traditional |
$92.91
|
| Rate for Payer: Caresource Just 4 Me |
$40.86
|
| Rate for Payer: Caresource Medicare |
$39.08
|
| Rate for Payer: Centivo/Paragon All Products |
$55.07
|
| Rate for Payer: Coventry/First Health All Products |
$222.70
|
| Rate for Payer: Frontpath All Products |
$48.33
|
| Rate for Payer: Humana ChoiceCare |
$185.58
|
| Rate for Payer: Humana Medicare |
$35.53
|
| Rate for Payer: Lucent/Coldwater Veneers |
$60.40
|
| Rate for Payer: Lutheran Preferred All Products |
$46.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$139.19
|
| Rate for Payer: PHP All Products |
$48.53
|
| Rate for Payer: Plain Church Group Ministry All Products |
$35.53
|
| Rate for Payer: Signature Care EPO |
$93.19
|
| Rate for Payer: Signature Care PPO |
$93.19
|
| Rate for Payer: Three Rivers Preferred All Products |
$43.00
|
| Rate for Payer: United Healthcare Commercial |
$48.33
|
| Rate for Payer: United Healthcare Medicare |
$92.79
|
|
|
PR TARSAL TUNNEL RELEASE
|
Professional
|
$963.18
|
|
|
Service Code
|
CPT 28035
|
| Hospital Charge Code |
Z12417
|
| Min. Negotiated Rate |
$337.42 |
| Max. Negotiated Rate |
$1,155.82 |
| Rate for Payer: Aetna Medicare |
$337.42
|
| Rate for Payer: Anthem Exchange |
$502.78
|
| Rate for Payer: Anthem Medicare |
$337.42
|
| Rate for Payer: Anthem PPO |
$502.78
|
| Rate for Payer: Anthem Traditional |
$502.78
|
| Rate for Payer: Caresource Just 4 Me |
$388.03
|
| Rate for Payer: Caresource Medicare |
$371.16
|
| Rate for Payer: Centivo/Paragon All Products |
$523.00
|
| Rate for Payer: Coventry/First Health All Products |
$1,155.82
|
| Rate for Payer: Frontpath All Products |
$455.73
|
| Rate for Payer: Humana ChoiceCare |
$963.18
|
| Rate for Payer: Humana Medicare |
$337.42
|
| Rate for Payer: Lucent/Coldwater Veneers |
$573.61
|
| Rate for Payer: Lutheran Preferred All Products |
$540.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$722.38
|
| Rate for Payer: PHP All Products |
$572.79
|
| Rate for Payer: Plain Church Group Ministry All Products |
$337.42
|
| Rate for Payer: Signature Care EPO |
$614.55
|
| Rate for Payer: Signature Care PPO |
$614.55
|
| Rate for Payer: Three Rivers Preferred All Products |
$506.00
|
| Rate for Payer: United Healthcare Commercial |
$404.59
|
| Rate for Payer: United Healthcare Medicare |
$481.59
|
|
|
PR TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG
|
Professional
|
$850.18
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
Z12541
|
| Min. Negotiated Rate |
$425.09 |
| Max. Negotiated Rate |
$1,020.22 |
| Rate for Payer: Aetna Medicare |
$435.72
|
| Rate for Payer: Anthem Exchange |
$458.18
|
| Rate for Payer: Anthem Medicare |
$435.72
|
| Rate for Payer: Anthem PPO |
$458.18
|
| Rate for Payer: Anthem Traditional |
$458.18
|
| Rate for Payer: Caresource Just 4 Me |
$501.08
|
| Rate for Payer: Caresource Medicare |
$479.29
|
| Rate for Payer: Centivo/Paragon All Products |
$675.37
|
| Rate for Payer: Coventry/First Health All Products |
$1,020.22
|
| Rate for Payer: Frontpath All Products |
$630.90
|
| Rate for Payer: Humana ChoiceCare |
$850.18
|
| Rate for Payer: Humana Medicare |
$435.72
|
| Rate for Payer: Lucent/Coldwater Veneers |
$740.72
|
| Rate for Payer: Lutheran Preferred All Products |
$697.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$637.63
|
| Rate for Payer: PHP All Products |
$595.13
|
| Rate for Payer: Plain Church Group Ministry All Products |
$435.72
|
| Rate for Payer: Signature Care EPO |
$646.49
|
| Rate for Payer: Signature Care PPO |
$646.49
|
| Rate for Payer: Three Rivers Preferred All Products |
$654.00
|
| Rate for Payer: United Healthcare Commercial |
$590.90
|
| Rate for Payer: United Healthcare Medicare |
$425.09
|
|
|
PR TEMPORAL ARTERY LIGATN OR BX
|
Professional
|
$564.84
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
Z12549
|
| Min. Negotiated Rate |
$187.91 |
| Max. Negotiated Rate |
$677.81 |
| Rate for Payer: Aetna Medicare |
$187.91
|
| Rate for Payer: Anthem Exchange |
$320.30
|
| Rate for Payer: Anthem Medicare |
$187.91
|
| Rate for Payer: Anthem PPO |
$320.30
|
| Rate for Payer: Anthem Traditional |
$320.30
|
| Rate for Payer: Caresource Just 4 Me |
$216.10
|
| Rate for Payer: Caresource Medicare |
$206.70
|
| Rate for Payer: Centivo/Paragon All Products |
$291.26
|
| Rate for Payer: Coventry/First Health All Products |
$677.81
|
| Rate for Payer: Frontpath All Products |
$265.64
|
| Rate for Payer: Humana ChoiceCare |
$564.84
|
| Rate for Payer: Humana Medicare |
$187.91
|
| Rate for Payer: Lucent/Coldwater Veneers |
$319.45
|
| Rate for Payer: Lutheran Preferred All Products |
$301.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$423.63
|
| Rate for Payer: PHP All Products |
$256.66
|
| Rate for Payer: Plain Church Group Ministry All Products |
$187.91
|
| Rate for Payer: Signature Care EPO |
$420.75
|
| Rate for Payer: Signature Care PPO |
$420.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$282.00
|
| Rate for Payer: United Healthcare Commercial |
$224.09
|
| Rate for Payer: United Healthcare Medicare |
$282.42
|
|
|
PR TENOTOMY ELBOW LATERAL/MEDIAL DEBRIDE OPEN
|
Professional
|
$968.46
|
|
|
Service Code
|
CPT 24358
|
| Hospital Charge Code |
Z12195
|
| Min. Negotiated Rate |
$484.23 |
| Max. Negotiated Rate |
$1,162.15 |
| Rate for Payer: Aetna Medicare |
$496.34
|
| Rate for Payer: Anthem Exchange |
$720.94
|
| Rate for Payer: Anthem Medicare |
$496.34
|
| Rate for Payer: Anthem PPO |
$720.94
|
| Rate for Payer: Anthem Traditional |
$720.94
|
| Rate for Payer: Caresource Just 4 Me |
$570.79
|
| Rate for Payer: Caresource Medicare |
$545.97
|
| Rate for Payer: Centivo/Paragon All Products |
$769.33
|
| Rate for Payer: Coventry/First Health All Products |
$1,162.15
|
| Rate for Payer: Frontpath All Products |
$685.05
|
| Rate for Payer: Humana ChoiceCare |
$968.46
|
| Rate for Payer: Humana Medicare |
$496.34
|
| Rate for Payer: Lucent/Coldwater Veneers |
$843.78
|
| Rate for Payer: Lutheran Preferred All Products |
$794.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$726.35
|
| Rate for Payer: PHP All Products |
$842.56
|
| Rate for Payer: Plain Church Group Ministry All Products |
$496.34
|
| Rate for Payer: Signature Care EPO |
$687.17
|
| Rate for Payer: Signature Care PPO |
$687.17
|
| Rate for Payer: Three Rivers Preferred All Products |
$745.00
|
| Rate for Payer: United Healthcare Commercial |
$555.09
|
| Rate for Payer: United Healthcare Medicare |
$484.23
|
|
|
PR TENOTOMY ELBOW LATERAL/MEDIAL DEBRIDE REPAIR
|
Professional
|
$1,210.08
|
|
|
Service Code
|
CPT 24359
|
| Hospital Charge Code |
Z12196
|
| Min. Negotiated Rate |
$605.04 |
| Max. Negotiated Rate |
$1,452.10 |
| Rate for Payer: Aetna Medicare |
$620.17
|
| Rate for Payer: Anthem Exchange |
$884.53
|
| Rate for Payer: Anthem Medicare |
$620.17
|
| Rate for Payer: Anthem PPO |
$884.53
|
| Rate for Payer: Anthem Traditional |
$884.53
|
| Rate for Payer: Caresource Just 4 Me |
$713.20
|
| Rate for Payer: Caresource Medicare |
$682.19
|
| Rate for Payer: Centivo/Paragon All Products |
$961.26
|
| Rate for Payer: Coventry/First Health All Products |
$1,452.10
|
| Rate for Payer: Frontpath All Products |
$859.55
|
| Rate for Payer: Humana ChoiceCare |
$1,210.08
|
| Rate for Payer: Humana Medicare |
$620.17
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,054.29
|
| Rate for Payer: Lutheran Preferred All Products |
$992.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$907.56
|
| Rate for Payer: PHP All Products |
$1,052.78
|
| Rate for Payer: Plain Church Group Ministry All Products |
$620.17
|
| Rate for Payer: Signature Care EPO |
$844.63
|
| Rate for Payer: Signature Care PPO |
$844.63
|
| Rate for Payer: Three Rivers Preferred All Products |
$930.00
|
| Rate for Payer: United Healthcare Commercial |
$701.15
|
| Rate for Payer: United Healthcare Medicare |
$605.04
|
|
|
PR THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF
|
Professional
|
$319.16
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
Z12822
|
| Min. Negotiated Rate |
$81.76 |
| Max. Negotiated Rate |
$382.99 |
| Rate for Payer: Aetna Medicare |
$81.76
|
| Rate for Payer: Anthem Exchange |
$174.50
|
| Rate for Payer: Anthem Medicare |
$81.76
|
| Rate for Payer: Anthem PPO |
$174.50
|
| Rate for Payer: Anthem Traditional |
$174.50
|
| Rate for Payer: Caresource Just 4 Me |
$94.02
|
| Rate for Payer: Caresource Medicare |
$89.94
|
| Rate for Payer: Centivo/Paragon All Products |
$126.73
|
| Rate for Payer: Coventry/First Health All Products |
$382.99
|
| Rate for Payer: Frontpath All Products |
$117.39
|
| Rate for Payer: Humana ChoiceCare |
$319.16
|
| Rate for Payer: Humana Medicare |
$81.76
|
| Rate for Payer: Lucent/Coldwater Veneers |
$138.99
|
| Rate for Payer: Lutheran Preferred All Products |
$131.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$239.37
|
| Rate for Payer: PHP All Products |
$139.60
|
| Rate for Payer: Plain Church Group Ministry All Products |
$81.76
|
| Rate for Payer: Signature Care EPO |
$271.47
|
| Rate for Payer: Signature Care PPO |
$271.47
|
| Rate for Payer: Three Rivers Preferred All Products |
$123.00
|
| Rate for Payer: United Healthcare Commercial |
$93.04
|
| Rate for Payer: United Healthcare Medicare |
$159.58
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING
|
Professional
|
$579.24
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
Z12522
|
| Min. Negotiated Rate |
$102.99 |
| Max. Negotiated Rate |
$825.10 |
| Rate for Payer: Aetna Medicare |
$102.99
|
| Rate for Payer: Anthem Exchange |
$825.10
|
| Rate for Payer: Anthem Medicare |
$102.99
|
| Rate for Payer: Anthem PPO |
$825.10
|
| Rate for Payer: Anthem Traditional |
$825.10
|
| Rate for Payer: Caresource Just 4 Me |
$118.44
|
| Rate for Payer: Caresource Medicare |
$113.29
|
| Rate for Payer: Centivo/Paragon All Products |
$159.63
|
| Rate for Payer: Coventry/First Health All Products |
$695.09
|
| Rate for Payer: Frontpath All Products |
$142.36
|
| Rate for Payer: Humana ChoiceCare |
$579.24
|
| Rate for Payer: Humana Medicare |
$102.99
|
| Rate for Payer: Lucent/Coldwater Veneers |
$175.08
|
| Rate for Payer: Lutheran Preferred All Products |
$165.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$434.43
|
| Rate for Payer: PHP All Products |
$140.67
|
| Rate for Payer: Plain Church Group Ministry All Products |
$102.99
|
| Rate for Payer: Signature Care EPO |
$259.85
|
| Rate for Payer: Signature Care PPO |
$259.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$154.00
|
| Rate for Payer: United Healthcare Commercial |
$141.66
|
| Rate for Payer: United Healthcare Medicare |
$289.62
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
$428.40
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
Z12521
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$715.42 |
| Rate for Payer: Aetna Medicare |
$82.80
|
| Rate for Payer: Anthem Exchange |
$715.42
|
| Rate for Payer: Anthem Medicare |
$82.80
|
| Rate for Payer: Anthem PPO |
$715.42
|
| Rate for Payer: Anthem Traditional |
$715.42
|
| Rate for Payer: Caresource Just 4 Me |
$95.22
|
| Rate for Payer: Caresource Medicare |
$91.08
|
| Rate for Payer: Centivo/Paragon All Products |
$128.34
|
| Rate for Payer: Coventry/First Health All Products |
$514.08
|
| Rate for Payer: Frontpath All Products |
$116.36
|
| Rate for Payer: Humana ChoiceCare |
$428.40
|
| Rate for Payer: Humana Medicare |
$82.80
|
| Rate for Payer: Lucent/Coldwater Veneers |
$140.76
|
| Rate for Payer: Lutheran Preferred All Products |
$132.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$321.30
|
| Rate for Payer: PHP All Products |
$113.09
|
| Rate for Payer: Plain Church Group Ministry All Products |
$82.80
|
| Rate for Payer: Signature Care EPO |
$324.89
|
| Rate for Payer: Signature Care PPO |
$324.89
|
| Rate for Payer: Three Rivers Preferred All Products |
$124.00
|
| Rate for Payer: United Healthcare Commercial |
$113.54
|
| Rate for Payer: United Healthcare Medicare |
$214.20
|
|
|
PR TIBIAL SCOPE/SURG/FX AID,UNICONDYLR
|
Professional
|
$1,418.02
|
|
|
Service Code
|
CPT 29855
|
| Hospital Charge Code |
Z12479
|
| Min. Negotiated Rate |
$709.01 |
| Max. Negotiated Rate |
$1,701.62 |
| Rate for Payer: Aetna Medicare |
$726.74
|
| Rate for Payer: Anthem Exchange |
$1,073.10
|
| Rate for Payer: Anthem Medicare |
$726.74
|
| Rate for Payer: Anthem PPO |
$1,073.10
|
| Rate for Payer: Anthem Traditional |
$1,073.10
|
| Rate for Payer: Caresource Just 4 Me |
$835.75
|
| Rate for Payer: Caresource Medicare |
$799.41
|
| Rate for Payer: Centivo/Paragon All Products |
$1,126.45
|
| Rate for Payer: Coventry/First Health All Products |
$1,701.62
|
| Rate for Payer: Frontpath All Products |
$1,013.52
|
| Rate for Payer: Humana ChoiceCare |
$1,418.02
|
| Rate for Payer: Humana Medicare |
$726.74
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,235.46
|
| Rate for Payer: Lutheran Preferred All Products |
$1,163.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,063.51
|
| Rate for Payer: PHP All Products |
$1,233.68
|
| Rate for Payer: Plain Church Group Ministry All Products |
$726.74
|
| Rate for Payer: Signature Care EPO |
$1,124.55
|
| Rate for Payer: Signature Care PPO |
$1,124.55
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,090.00
|
| Rate for Payer: United Healthcare Commercial |
$852.31
|
| Rate for Payer: United Healthcare Medicare |
$709.01
|
|
|
PR TILT TABLE EVALUATION
|
Professional
|
$170.82
|
|
|
Service Code
|
CPT 93660
|
| Hospital Charge Code |
Z13126
|
| Min. Negotiated Rate |
$128.12 |
| Max. Negotiated Rate |
$258.04 |
| Rate for Payer: Aetna Medicare |
$151.79
|
| Rate for Payer: Anthem Exchange |
$162.00
|
| Rate for Payer: Anthem Medicare |
$151.79
|
| Rate for Payer: Anthem PPO |
$162.00
|
| Rate for Payer: Anthem Traditional |
$162.00
|
| Rate for Payer: Caresource Just 4 Me |
$174.56
|
| Rate for Payer: Caresource Medicare |
$166.97
|
| Rate for Payer: Centivo/Paragon All Products |
$235.27
|
| Rate for Payer: Coventry/First Health All Products |
$204.98
|
| Rate for Payer: Frontpath All Products |
$170.02
|
| Rate for Payer: Humana ChoiceCare |
$170.82
|
| Rate for Payer: Humana Medicare |
$151.79
|
| Rate for Payer: Lucent/Coldwater Veneers |
$258.04
|
| Rate for Payer: Lutheran Preferred All Products |
$197.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$128.12
|
| Rate for Payer: PHP All Products |
$217.69
|
| Rate for Payer: Plain Church Group Ministry All Products |
$151.79
|
| Rate for Payer: Signature Care EPO |
$178.54
|
| Rate for Payer: Signature Care PPO |
$178.54
|
| Rate for Payer: Three Rivers Preferred All Products |
$182.00
|
| Rate for Payer: United Healthcare Commercial |
$202.43
|
|
|
PR TINNITUS ASSESSMENT
|
Professional
|
$127.90
|
|
|
Service Code
|
CPT 92625
|
| Hospital Charge Code |
Z13069
|
| Min. Negotiated Rate |
$42.13 |
| Max. Negotiated Rate |
$153.48 |
| Rate for Payer: Aetna Medicare |
$58.75
|
| Rate for Payer: Anthem Exchange |
$42.13
|
| Rate for Payer: Anthem Medicare |
$58.75
|
| Rate for Payer: Anthem PPO |
$42.13
|
| Rate for Payer: Anthem Traditional |
$42.13
|
| Rate for Payer: Caresource Just 4 Me |
$67.56
|
| Rate for Payer: Caresource Medicare |
$64.62
|
| Rate for Payer: Centivo/Paragon All Products |
$91.06
|
| Rate for Payer: Coventry/First Health All Products |
$153.48
|
| Rate for Payer: Frontpath All Products |
$66.72
|
| Rate for Payer: Humana ChoiceCare |
$127.90
|
| Rate for Payer: Humana Medicare |
$58.75
|
| Rate for Payer: Lucent/Coldwater Veneers |
$99.88
|
| Rate for Payer: Lutheran Preferred All Products |
$76.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$95.93
|
| Rate for Payer: PHP All Products |
$83.12
|
| Rate for Payer: Plain Church Group Ministry All Products |
$58.75
|
| Rate for Payer: Signature Care EPO |
$57.54
|
| Rate for Payer: Signature Care PPO |
$57.54
|
| Rate for Payer: Three Rivers Preferred All Products |
$71.00
|
| Rate for Payer: United Healthcare Commercial |
$68.80
|
| Rate for Payer: United Healthcare Medicare |
$63.95
|
|
|
PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
|
Professional
|
$27.34
|
|
|
Service Code
|
CPT 99406
|
| Hospital Charge Code |
Z13221
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$32.81 |
| Rate for Payer: Aetna Medicare |
$11.23
|
| Rate for Payer: Anthem Exchange |
$16.75
|
| Rate for Payer: Anthem Medicare |
$11.23
|
| Rate for Payer: Anthem PPO |
$16.75
|
| Rate for Payer: Anthem Traditional |
$16.75
|
| Rate for Payer: Caresource Just 4 Me |
$12.91
|
| Rate for Payer: Caresource Medicare |
$12.35
|
| Rate for Payer: Centivo/Paragon All Products |
$17.41
|
| Rate for Payer: Coventry/First Health All Products |
$32.81
|
| Rate for Payer: Frontpath All Products |
$12.51
|
| Rate for Payer: Humana ChoiceCare |
$27.34
|
| Rate for Payer: Humana Medicare |
$11.23
|
| Rate for Payer: Lucent/Coldwater Veneers |
$19.09
|
| Rate for Payer: Lutheran Preferred All Products |
$12.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$20.50
|
| Rate for Payer: PHP All Products |
$11.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$11.23
|
| Rate for Payer: Signature Care EPO |
$12.36
|
| Rate for Payer: Signature Care PPO |
$12.36
|
| Rate for Payer: Three Rivers Preferred All Products |
$12.00
|
| Rate for Payer: United Healthcare Commercial |
$11.75
|
| Rate for Payer: United Healthcare Medicare |
$13.67
|
|
|
PR TONE DECAY HEARING TEST
|
Professional
|
$59.34
|
|
|
Service Code
|
CPT 92563
|
| Hospital Charge Code |
Z13047
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$71.21 |
| Rate for Payer: Aetna Medicare |
$30.41
|
| Rate for Payer: Anthem Exchange |
$15.00
|
| Rate for Payer: Anthem Medicare |
$30.41
|
| Rate for Payer: Anthem PPO |
$15.00
|
| Rate for Payer: Anthem Traditional |
$15.00
|
| Rate for Payer: Caresource Just 4 Me |
$34.97
|
| Rate for Payer: Caresource Medicare |
$33.45
|
| Rate for Payer: Centivo/Paragon All Products |
$47.14
|
| Rate for Payer: Coventry/First Health All Products |
$71.21
|
| Rate for Payer: Frontpath All Products |
$32.74
|
| Rate for Payer: Humana ChoiceCare |
$59.34
|
| Rate for Payer: Humana Medicare |
$30.41
|
| Rate for Payer: Lucent/Coldwater Veneers |
$51.70
|
| Rate for Payer: Lutheran Preferred All Products |
$40.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$44.51
|
| Rate for Payer: PHP All Products |
$43.03
|
| Rate for Payer: Plain Church Group Ministry All Products |
$30.41
|
| Rate for Payer: Signature Care EPO |
$24.76
|
| Rate for Payer: Signature Care PPO |
$24.76
|
| Rate for Payer: Three Rivers Preferred All Products |
$36.00
|
| Rate for Payer: United Healthcare Commercial |
$22.60
|
| Rate for Payer: United Healthcare Medicare |
$29.67
|
|
|
PR TOTAL ABDOM HYSTERECTOMY
|
Professional
|
$1,847.58
|
|
|
Service Code
|
CPT 58150
|
| Hospital Charge Code |
Z12735
|
| Min. Negotiated Rate |
$923.79 |
| Max. Negotiated Rate |
$2,217.10 |
| Rate for Payer: Aetna Medicare |
$947.20
|
| Rate for Payer: Anthem Exchange |
$1,202.18
|
| Rate for Payer: Anthem Medicare |
$947.20
|
| Rate for Payer: Anthem PPO |
$1,202.18
|
| Rate for Payer: Anthem Traditional |
$1,202.18
|
| Rate for Payer: Caresource Just 4 Me |
$1,089.28
|
| Rate for Payer: Caresource Medicare |
$1,041.92
|
| Rate for Payer: Centivo/Paragon All Products |
$1,468.16
|
| Rate for Payer: Coventry/First Health All Products |
$2,217.10
|
| Rate for Payer: Frontpath All Products |
$1,325.65
|
| Rate for Payer: Humana ChoiceCare |
$1,847.58
|
| Rate for Payer: Humana Medicare |
$947.20
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,610.24
|
| Rate for Payer: Lutheran Preferred All Products |
$1,326.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,385.68
|
| Rate for Payer: PHP All Products |
$1,219.40
|
| Rate for Payer: Plain Church Group Ministry All Products |
$947.20
|
| Rate for Payer: Signature Care EPO |
$1,214.65
|
| Rate for Payer: Signature Care PPO |
$1,214.65
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,231.00
|
| Rate for Payer: United Healthcare Commercial |
$1,115.96
|
| Rate for Payer: United Healthcare Medicare |
$923.79
|
|
|
PR TOTAL HIP ARTHROPLASTY
|
Professional
|
$2,314.24
|
|
|
Service Code
|
CPT 27130
|
| Hospital Charge Code |
Z12311
|
| Min. Negotiated Rate |
$1,157.12 |
| Max. Negotiated Rate |
$2,777.09 |
| Rate for Payer: Aetna Medicare |
$1,186.05
|
| Rate for Payer: Anthem Exchange |
$1,975.00
|
| Rate for Payer: Anthem Medicare |
$1,186.05
|
| Rate for Payer: Anthem PPO |
$1,975.00
|
| Rate for Payer: Anthem Traditional |
$1,975.00
|
| Rate for Payer: Caresource Just 4 Me |
$1,363.96
|
| Rate for Payer: Caresource Medicare |
$1,304.65
|
| Rate for Payer: Centivo/Paragon All Products |
$1,838.38
|
| Rate for Payer: Coventry/First Health All Products |
$2,777.09
|
| Rate for Payer: Frontpath All Products |
$1,671.01
|
| Rate for Payer: Humana ChoiceCare |
$2,314.24
|
| Rate for Payer: Humana Medicare |
$1,186.05
|
| Rate for Payer: Lucent/Coldwater Veneers |
$2,016.28
|
| Rate for Payer: Lutheran Preferred All Products |
$1,898.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,735.68
|
| Rate for Payer: PHP All Products |
$2,013.39
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,186.05
|
| Rate for Payer: Signature Care EPO |
$2,025.75
|
| Rate for Payer: Signature Care PPO |
$2,025.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,779.00
|
| Rate for Payer: United Healthcare Commercial |
$1,589.68
|
| Rate for Payer: United Healthcare Medicare |
$1,157.12
|
|
|
PR TOTAL KNEE ARTHROPLASTY
|
Professional
|
$2,312.12
|
|
|
Service Code
|
CPT 27447
|
| Hospital Charge Code |
Z12352
|
| Min. Negotiated Rate |
$1,156.06 |
| Max. Negotiated Rate |
$2,774.54 |
| Rate for Payer: Aetna Medicare |
$1,184.96
|
| Rate for Payer: Anthem Exchange |
$2,089.40
|
| Rate for Payer: Anthem Medicare |
$1,184.96
|
| Rate for Payer: Anthem PPO |
$2,089.40
|
| Rate for Payer: Anthem Traditional |
$2,089.40
|
| Rate for Payer: Caresource Just 4 Me |
$1,362.70
|
| Rate for Payer: Caresource Medicare |
$1,303.46
|
| Rate for Payer: Centivo/Paragon All Products |
$1,836.69
|
| Rate for Payer: Coventry/First Health All Products |
$2,774.54
|
| Rate for Payer: Frontpath All Products |
$1,669.28
|
| Rate for Payer: Humana ChoiceCare |
$2,312.12
|
| Rate for Payer: Humana Medicare |
$1,184.96
|
| Rate for Payer: Lucent/Coldwater Veneers |
$2,014.43
|
| Rate for Payer: Lutheran Preferred All Products |
$1,896.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,734.09
|
| Rate for Payer: PHP All Products |
$2,011.54
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,184.96
|
| Rate for Payer: Signature Care EPO |
$2,023.88
|
| Rate for Payer: Signature Care PPO |
$2,023.88
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,777.00
|
| Rate for Payer: United Healthcare Commercial |
$1,701.71
|
| Rate for Payer: United Healthcare Medicare |
$1,156.06
|
|
