|
PR VAG HYST,RMV TUBE/OVARY,FIX ENTEROCE
|
Professional
|
$1,817.54
|
|
|
Service Code
|
CPT 58263
|
| Hospital Charge Code |
Z12739
|
| Min. Negotiated Rate |
$908.77 |
| Max. Negotiated Rate |
$2,181.05 |
| Rate for Payer: Aetna Medicare |
$931.48
|
| Rate for Payer: Anthem Exchange |
$1,266.80
|
| Rate for Payer: Anthem Medicare |
$931.48
|
| Rate for Payer: Anthem PPO |
$1,266.80
|
| Rate for Payer: Anthem Traditional |
$1,266.80
|
| Rate for Payer: Caresource Just 4 Me |
$1,071.20
|
| Rate for Payer: Caresource Medicare |
$1,024.63
|
| Rate for Payer: Centivo/Paragon All Products |
$1,443.79
|
| Rate for Payer: Coventry/First Health All Products |
$2,181.05
|
| Rate for Payer: Frontpath All Products |
$1,305.46
|
| Rate for Payer: Humana ChoiceCare |
$1,817.54
|
| Rate for Payer: Humana Medicare |
$931.48
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,583.52
|
| Rate for Payer: Lutheran Preferred All Products |
$1,304.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,363.15
|
| Rate for Payer: PHP All Products |
$1,199.57
|
| Rate for Payer: Plain Church Group Ministry All Products |
$931.48
|
| Rate for Payer: Signature Care EPO |
$1,197.65
|
| Rate for Payer: Signature Care PPO |
$1,197.65
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,211.00
|
| Rate for Payer: United Healthcare Commercial |
$1,121.56
|
| Rate for Payer: United Healthcare Medicare |
$908.77
|
|
|
PR VAG HYST,UTERUS >250 GMS
|
Professional
|
$2,102.68
|
|
|
Service Code
|
CPT 58290
|
| Hospital Charge Code |
Z12741
|
| Min. Negotiated Rate |
$1,051.34 |
| Max. Negotiated Rate |
$2,523.22 |
| Rate for Payer: Aetna Medicare |
$1,077.62
|
| Rate for Payer: Anthem Exchange |
$1,488.54
|
| Rate for Payer: Anthem Medicare |
$1,077.62
|
| Rate for Payer: Anthem PPO |
$1,488.54
|
| Rate for Payer: Anthem Traditional |
$1,488.54
|
| Rate for Payer: Caresource Just 4 Me |
$1,239.26
|
| Rate for Payer: Caresource Medicare |
$1,185.38
|
| Rate for Payer: Centivo/Paragon All Products |
$1,670.31
|
| Rate for Payer: Coventry/First Health All Products |
$2,523.22
|
| Rate for Payer: Frontpath All Products |
$1,514.40
|
| Rate for Payer: Humana ChoiceCare |
$2,102.68
|
| Rate for Payer: Humana Medicare |
$1,077.62
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,831.95
|
| Rate for Payer: Lutheran Preferred All Products |
$1,509.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,577.01
|
| Rate for Payer: PHP All Products |
$1,387.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,077.62
|
| Rate for Payer: Signature Care EPO |
$1,380.40
|
| Rate for Payer: Signature Care PPO |
$1,380.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,401.00
|
| Rate for Payer: United Healthcare Commercial |
$1,305.84
|
| Rate for Payer: United Healthcare Medicare |
$1,051.34
|
|
|
PR VAG HYST,UTERUS >250 GMS,REM TUBE/OVARY
|
Professional
|
$2,272.02
|
|
|
Service Code
|
CPT 58291
|
| Hospital Charge Code |
Z12742
|
| Min. Negotiated Rate |
$1,136.01 |
| Max. Negotiated Rate |
$2,726.42 |
| Rate for Payer: Aetna Medicare |
$1,164.41
|
| Rate for Payer: Anthem Exchange |
$1,624.12
|
| Rate for Payer: Anthem Medicare |
$1,164.41
|
| Rate for Payer: Anthem PPO |
$1,624.12
|
| Rate for Payer: Anthem Traditional |
$1,624.12
|
| Rate for Payer: Caresource Just 4 Me |
$1,339.07
|
| Rate for Payer: Caresource Medicare |
$1,280.85
|
| Rate for Payer: Centivo/Paragon All Products |
$1,804.84
|
| Rate for Payer: Coventry/First Health All Products |
$2,726.42
|
| Rate for Payer: Frontpath All Products |
$1,637.12
|
| Rate for Payer: Humana ChoiceCare |
$2,272.02
|
| Rate for Payer: Humana Medicare |
$1,164.41
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,979.50
|
| Rate for Payer: Lutheran Preferred All Products |
$1,630.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,704.01
|
| Rate for Payer: PHP All Products |
$1,499.53
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,164.41
|
| Rate for Payer: Signature Care EPO |
$1,518.10
|
| Rate for Payer: Signature Care PPO |
$1,518.10
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,514.00
|
| Rate for Payer: United Healthcare Commercial |
$1,419.24
|
| Rate for Payer: United Healthcare Medicare |
$1,136.01
|
|
|
PR VAGINAL HYSTERECTOMY,UTERUS 250 GMS/<
|
Professional
|
$1,534.34
|
|
|
Service Code
|
CPT 58260
|
| Hospital Charge Code |
Z12737
|
| Min. Negotiated Rate |
$767.17 |
| Max. Negotiated Rate |
$1,841.21 |
| Rate for Payer: Aetna Medicare |
$786.35
|
| Rate for Payer: Anthem Exchange |
$1,039.67
|
| Rate for Payer: Anthem Medicare |
$786.35
|
| Rate for Payer: Anthem PPO |
$1,039.67
|
| Rate for Payer: Anthem Traditional |
$1,039.67
|
| Rate for Payer: Caresource Just 4 Me |
$904.30
|
| Rate for Payer: Caresource Medicare |
$864.99
|
| Rate for Payer: Centivo/Paragon All Products |
$1,218.84
|
| Rate for Payer: Coventry/First Health All Products |
$1,841.21
|
| Rate for Payer: Frontpath All Products |
$1,100.88
|
| Rate for Payer: Humana ChoiceCare |
$1,534.34
|
| Rate for Payer: Humana Medicare |
$786.35
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,336.80
|
| Rate for Payer: Lutheran Preferred All Products |
$1,101.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,150.75
|
| Rate for Payer: PHP All Products |
$1,012.67
|
| Rate for Payer: Plain Church Group Ministry All Products |
$786.35
|
| Rate for Payer: Signature Care EPO |
$1,049.75
|
| Rate for Payer: Signature Care PPO |
$1,049.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,022.00
|
| Rate for Payer: United Healthcare Commercial |
$931.06
|
| Rate for Payer: United Healthcare Medicare |
$767.17
|
|
|
PR VASCULAR SURGERY PROCEDURE UNLIST
|
Professional
|
$708.53
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
Z12550
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$850.24 |
| Rate for Payer: Anthem Exchange |
$0.01
|
| Rate for Payer: Anthem PPO |
$0.01
|
| Rate for Payer: Anthem Traditional |
$0.01
|
| Rate for Payer: Coventry/First Health All Products |
$850.24
|
| Rate for Payer: Humana ChoiceCare |
$708.53
|
| Rate for Payer: Lutheran Preferred All Products |
$602.25
|
| Rate for Payer: PHCS/Multiplan All Products |
$531.40
|
| Rate for Payer: Signature Care EPO |
$451.69
|
| Rate for Payer: Signature Care PPO |
$451.69
|
| Rate for Payer: Three Rivers Preferred All Products |
$425.12
|
|
|
PR VENT TUBE REMVL REQ GEN ANESTHESIA
|
Professional
|
$234.64
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
Z12860
|
| Min. Negotiated Rate |
$56.65 |
| Max. Negotiated Rate |
$281.57 |
| Rate for Payer: Aetna Medicare |
$56.65
|
| Rate for Payer: Anthem Exchange |
$107.66
|
| Rate for Payer: Anthem Medicare |
$56.65
|
| Rate for Payer: Anthem PPO |
$107.66
|
| Rate for Payer: Anthem Traditional |
$107.66
|
| Rate for Payer: Caresource Just 4 Me |
$65.15
|
| Rate for Payer: Caresource Medicare |
$62.32
|
| Rate for Payer: Centivo/Paragon All Products |
$87.81
|
| Rate for Payer: Coventry/First Health All Products |
$281.57
|
| Rate for Payer: Frontpath All Products |
$76.84
|
| Rate for Payer: Humana ChoiceCare |
$234.64
|
| Rate for Payer: Humana Medicare |
$56.65
|
| Rate for Payer: Lucent/Coldwater Veneers |
$96.30
|
| Rate for Payer: Lutheran Preferred All Products |
$91.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$175.98
|
| Rate for Payer: PHP All Products |
$71.85
|
| Rate for Payer: Plain Church Group Ministry All Products |
$56.65
|
| Rate for Payer: Signature Care EPO |
$140.25
|
| Rate for Payer: Signature Care PPO |
$140.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$85.00
|
| Rate for Payer: United Healthcare Commercial |
$68.35
|
| Rate for Payer: United Healthcare Medicare |
$117.32
|
|
|
PR VENT TUBE REMVL REQ GEN ANESTHESIA
|
Professional
|
$469.28
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
Z12861
|
| Min. Negotiated Rate |
$56.65 |
| Max. Negotiated Rate |
$563.14 |
| Rate for Payer: Aetna Medicare |
$56.65
|
| Rate for Payer: Anthem Exchange |
$107.66
|
| Rate for Payer: Anthem Medicare |
$56.65
|
| Rate for Payer: Anthem PPO |
$107.66
|
| Rate for Payer: Anthem Traditional |
$107.66
|
| Rate for Payer: Caresource Just 4 Me |
$65.15
|
| Rate for Payer: Caresource Medicare |
$62.32
|
| Rate for Payer: Centivo/Paragon All Products |
$87.81
|
| Rate for Payer: Coventry/First Health All Products |
$563.14
|
| Rate for Payer: Frontpath All Products |
$76.84
|
| Rate for Payer: Humana ChoiceCare |
$469.28
|
| Rate for Payer: Humana Medicare |
$56.65
|
| Rate for Payer: Lucent/Coldwater Veneers |
$96.30
|
| Rate for Payer: Lutheran Preferred All Products |
$91.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$351.96
|
| Rate for Payer: PHP All Products |
$71.85
|
| Rate for Payer: Plain Church Group Ministry All Products |
$56.65
|
| Rate for Payer: Signature Care EPO |
$140.25
|
| Rate for Payer: Signature Care PPO |
$140.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$85.00
|
| Rate for Payer: United Healthcare Commercial |
$68.35
|
| Rate for Payer: United Healthcare Medicare |
$117.32
|
|
|
PR VISUAL AUDIOMETRY (VRA)
|
Professional
|
$84.26
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
Z13057
|
| Min. Negotiated Rate |
$28.20 |
| Max. Negotiated Rate |
$101.11 |
| Rate for Payer: Aetna Medicare |
$35.77
|
| Rate for Payer: Anthem Exchange |
$28.20
|
| Rate for Payer: Anthem Medicare |
$35.77
|
| Rate for Payer: Anthem PPO |
$28.20
|
| Rate for Payer: Anthem Traditional |
$28.20
|
| Rate for Payer: Caresource Just 4 Me |
$41.14
|
| Rate for Payer: Caresource Medicare |
$39.35
|
| Rate for Payer: Centivo/Paragon All Products |
$55.44
|
| Rate for Payer: Coventry/First Health All Products |
$101.11
|
| Rate for Payer: Frontpath All Products |
$41.17
|
| Rate for Payer: Humana ChoiceCare |
$84.26
|
| Rate for Payer: Humana Medicare |
$35.77
|
| Rate for Payer: Lucent/Coldwater Veneers |
$60.81
|
| Rate for Payer: Lutheran Preferred All Products |
$47.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$63.20
|
| Rate for Payer: PHP All Products |
$50.61
|
| Rate for Payer: Plain Church Group Ministry All Products |
$35.77
|
| Rate for Payer: Signature Care EPO |
$37.55
|
| Rate for Payer: Signature Care PPO |
$37.55
|
| Rate for Payer: Three Rivers Preferred All Products |
$43.00
|
| Rate for Payer: United Healthcare Commercial |
$48.49
|
| Rate for Payer: United Healthcare Medicare |
$42.13
|
|
|
PR VISUAL SCREENING TEST, BILAT
|
Professional
|
$5.14
|
|
|
Service Code
|
CPT 99173
|
| Hospital Charge Code |
Z13154
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$6.17 |
| Rate for Payer: Anthem Exchange |
$2.48
|
| Rate for Payer: Anthem PPO |
$2.48
|
| Rate for Payer: Anthem Traditional |
$2.48
|
| Rate for Payer: Coventry/First Health All Products |
$6.17
|
| Rate for Payer: Frontpath All Products |
$2.93
|
| Rate for Payer: Humana ChoiceCare |
$5.14
|
| Rate for Payer: Lutheran Preferred All Products |
$3.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$3.85
|
| Rate for Payer: PHP All Products |
$3.08
|
| Rate for Payer: Signature Care EPO |
$5.30
|
| Rate for Payer: Signature Care PPO |
$5.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$3.00
|
| Rate for Payer: United Healthcare Commercial |
$2.31
|
| Rate for Payer: United Healthcare Medicare |
$2.57
|
|
|
PR WEDGE BIOPSY OF LIVER
|
Professional
|
$1,516.92
|
|
|
Service Code
|
CPT 47100
|
| Hospital Charge Code |
Z12653
|
| Min. Negotiated Rate |
$586.30 |
| Max. Negotiated Rate |
$1,820.30 |
| Rate for Payer: Aetna Medicare |
$777.42
|
| Rate for Payer: Anthem Exchange |
$586.30
|
| Rate for Payer: Anthem Medicare |
$777.42
|
| Rate for Payer: Anthem PPO |
$586.30
|
| Rate for Payer: Anthem Traditional |
$586.30
|
| Rate for Payer: Caresource Just 4 Me |
$894.03
|
| Rate for Payer: Caresource Medicare |
$855.16
|
| Rate for Payer: Centivo/Paragon All Products |
$1,205.00
|
| Rate for Payer: Coventry/First Health All Products |
$1,820.30
|
| Rate for Payer: Frontpath All Products |
$1,119.13
|
| Rate for Payer: Humana ChoiceCare |
$1,516.92
|
| Rate for Payer: Humana Medicare |
$777.42
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,321.61
|
| Rate for Payer: Lutheran Preferred All Products |
$1,166.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,137.69
|
| Rate for Payer: PHP All Products |
$1,327.31
|
| Rate for Payer: Plain Church Group Ministry All Products |
$777.42
|
| Rate for Payer: Signature Care EPO |
$1,010.65
|
| Rate for Payer: Signature Care PPO |
$1,010.65
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,088.00
|
| Rate for Payer: United Healthcare Commercial |
$881.53
|
| Rate for Payer: United Healthcare Medicare |
$758.46
|
|
|
PR WEDGING OF CAST
|
Professional
|
$178.54
|
|
|
Service Code
|
CPT 29740
|
| Hospital Charge Code |
Z12468
|
| Min. Negotiated Rate |
$63.41 |
| Max. Negotiated Rate |
$214.25 |
| Rate for Payer: Aetna Medicare |
$63.41
|
| Rate for Payer: Anthem Exchange |
$122.99
|
| Rate for Payer: Anthem Medicare |
$63.41
|
| Rate for Payer: Anthem PPO |
$122.99
|
| Rate for Payer: Anthem Traditional |
$122.99
|
| Rate for Payer: Caresource Just 4 Me |
$72.92
|
| Rate for Payer: Caresource Medicare |
$69.75
|
| Rate for Payer: Centivo/Paragon All Products |
$98.29
|
| Rate for Payer: Coventry/First Health All Products |
$214.25
|
| Rate for Payer: Frontpath All Products |
$90.05
|
| Rate for Payer: Humana ChoiceCare |
$178.54
|
| Rate for Payer: Humana Medicare |
$63.41
|
| Rate for Payer: Lucent/Coldwater Veneers |
$107.80
|
| Rate for Payer: Lutheran Preferred All Products |
$101.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$133.91
|
| Rate for Payer: PHP All Products |
$107.65
|
| Rate for Payer: Plain Church Group Ministry All Products |
$63.41
|
| Rate for Payer: Signature Care EPO |
$130.05
|
| Rate for Payer: Signature Care PPO |
$130.05
|
| Rate for Payer: Three Rivers Preferred All Products |
$95.00
|
| Rate for Payer: United Healthcare Commercial |
$75.23
|
| Rate for Payer: United Healthcare Medicare |
$89.27
|
|
|
PR WINDOWING OF CAST
|
Professional
|
$116.00
|
|
|
Service Code
|
CPT 29730
|
| Hospital Charge Code |
Z12467
|
| Min. Negotiated Rate |
$41.24 |
| Max. Negotiated Rate |
$139.20 |
| Rate for Payer: Aetna Medicare |
$41.24
|
| Rate for Payer: Anthem Exchange |
$83.86
|
| Rate for Payer: Anthem Medicare |
$41.24
|
| Rate for Payer: Anthem PPO |
$83.86
|
| Rate for Payer: Anthem Traditional |
$83.86
|
| Rate for Payer: Caresource Just 4 Me |
$47.43
|
| Rate for Payer: Caresource Medicare |
$45.36
|
| Rate for Payer: Centivo/Paragon All Products |
$63.92
|
| Rate for Payer: Coventry/First Health All Products |
$139.20
|
| Rate for Payer: Frontpath All Products |
$57.30
|
| Rate for Payer: Humana ChoiceCare |
$116.00
|
| Rate for Payer: Humana Medicare |
$41.24
|
| Rate for Payer: Lucent/Coldwater Veneers |
$70.11
|
| Rate for Payer: Lutheran Preferred All Products |
$66.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$87.00
|
| Rate for Payer: PHP All Products |
$70.01
|
| Rate for Payer: Plain Church Group Ministry All Products |
$41.24
|
| Rate for Payer: Signature Care EPO |
$88.40
|
| Rate for Payer: Signature Care PPO |
$88.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$62.00
|
| Rate for Payer: United Healthcare Commercial |
$51.54
|
| Rate for Payer: United Healthcare Medicare |
$58.00
|
|
|
PR WND PREP PED, FACE/NCK/HND/FT/GEN 1ST 100 CM
|
Professional
|
$719.30
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
Z12075
|
| Min. Negotiated Rate |
$242.37 |
| Max. Negotiated Rate |
$863.16 |
| Rate for Payer: Aetna Medicare |
$242.37
|
| Rate for Payer: Anthem Exchange |
$436.07
|
| Rate for Payer: Anthem Medicare |
$242.37
|
| Rate for Payer: Anthem PPO |
$436.07
|
| Rate for Payer: Anthem Traditional |
$436.07
|
| Rate for Payer: Caresource Just 4 Me |
$278.73
|
| Rate for Payer: Caresource Medicare |
$266.61
|
| Rate for Payer: Centivo/Paragon All Products |
$375.67
|
| Rate for Payer: Coventry/First Health All Products |
$863.16
|
| Rate for Payer: Frontpath All Products |
$338.26
|
| Rate for Payer: Humana ChoiceCare |
$719.30
|
| Rate for Payer: Humana Medicare |
$242.37
|
| Rate for Payer: Lucent/Coldwater Veneers |
$412.03
|
| Rate for Payer: Lutheran Preferred All Products |
$315.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$539.47
|
| Rate for Payer: PHP All Products |
$331.05
|
| Rate for Payer: Plain Church Group Ministry All Products |
$242.37
|
| Rate for Payer: Signature Care EPO |
$368.05
|
| Rate for Payer: Signature Care PPO |
$368.05
|
| Rate for Payer: Three Rivers Preferred All Products |
$291.00
|
| Rate for Payer: United Healthcare Commercial |
$311.79
|
| Rate for Payer: United Healthcare Medicare |
$359.65
|
|
|
PR WRIST ARTHROSCOP,RELEASE XVERS LIG
|
Professional
|
$935.76
|
|
|
Service Code
|
CPT 29848
|
| Hospital Charge Code |
Z12478
|
| Min. Negotiated Rate |
$467.88 |
| Max. Negotiated Rate |
$1,122.91 |
| Rate for Payer: Aetna Medicare |
$479.58
|
| Rate for Payer: Anthem Medicare |
$479.58
|
| Rate for Payer: Caresource Just 4 Me |
$551.52
|
| Rate for Payer: Caresource Medicare |
$527.54
|
| Rate for Payer: Centivo/Paragon All Products |
$743.35
|
| Rate for Payer: Coventry/First Health All Products |
$1,122.91
|
| Rate for Payer: Frontpath All Products |
$659.11
|
| Rate for Payer: Humana ChoiceCare |
$935.76
|
| Rate for Payer: Humana Medicare |
$479.58
|
| Rate for Payer: Lucent/Coldwater Veneers |
$815.29
|
| Rate for Payer: PHCS/Multiplan All Products |
$701.82
|
| Rate for Payer: PHP All Products |
$814.11
|
| Rate for Payer: Plain Church Group Ministry All Products |
$479.58
|
| Rate for Payer: Signature Care EPO |
$632.40
|
| Rate for Payer: Signature Care PPO |
$632.40
|
| Rate for Payer: United Healthcare Commercial |
$529.69
|
| Rate for Payer: United Healthcare Medicare |
$467.88
|
|
|
PR XFER SINGLE DEEP LOW LEG TENDON
|
Professional
|
$1,356.62
|
|
|
Service Code
|
CPT 27691
|
| Hospital Charge Code |
Z12383
|
| Min. Negotiated Rate |
$678.31 |
| Max. Negotiated Rate |
$1,627.94 |
| Rate for Payer: Aetna Medicare |
$695.27
|
| Rate for Payer: Anthem Exchange |
$947.40
|
| Rate for Payer: Anthem Medicare |
$695.27
|
| Rate for Payer: Anthem PPO |
$947.40
|
| Rate for Payer: Anthem Traditional |
$947.40
|
| Rate for Payer: Caresource Just 4 Me |
$799.56
|
| Rate for Payer: Caresource Medicare |
$764.80
|
| Rate for Payer: Centivo/Paragon All Products |
$1,077.67
|
| Rate for Payer: Coventry/First Health All Products |
$1,627.94
|
| Rate for Payer: Frontpath All Products |
$962.47
|
| Rate for Payer: Humana ChoiceCare |
$1,356.62
|
| Rate for Payer: Humana Medicare |
$695.27
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,181.96
|
| Rate for Payer: Lutheran Preferred All Products |
$1,112.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,017.46
|
| Rate for Payer: PHP All Products |
$1,180.27
|
| Rate for Payer: Plain Church Group Ministry All Products |
$695.27
|
| Rate for Payer: Signature Care EPO |
$1,041.25
|
| Rate for Payer: Signature Care PPO |
$1,041.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,043.00
|
| Rate for Payer: United Healthcare Commercial |
$817.31
|
| Rate for Payer: United Healthcare Medicare |
$678.31
|
|
|
PR XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS
|
Professional
|
$34.54
|
|
|
Service Code
|
CPT 93227
|
| Hospital Charge Code |
Z13079
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$41.45 |
| Rate for Payer: Aetna Medicare |
$17.70
|
| Rate for Payer: Anthem Exchange |
$25.12
|
| Rate for Payer: Anthem Medicare |
$17.70
|
| Rate for Payer: Anthem PPO |
$25.12
|
| Rate for Payer: Anthem Traditional |
$25.12
|
| Rate for Payer: Caresource Just 4 Me |
$20.35
|
| Rate for Payer: Caresource Medicare |
$19.47
|
| Rate for Payer: Centivo/Paragon All Products |
$27.43
|
| Rate for Payer: Coventry/First Health All Products |
$41.45
|
| Rate for Payer: Frontpath All Products |
$20.13
|
| Rate for Payer: Humana ChoiceCare |
$34.54
|
| Rate for Payer: Humana Medicare |
$17.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$30.09
|
| Rate for Payer: Lutheran Preferred All Products |
$28.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$25.91
|
| Rate for Payer: PHP All Products |
$25.38
|
| Rate for Payer: Plain Church Group Ministry All Products |
$17.70
|
| Rate for Payer: Signature Care EPO |
$30.63
|
| Rate for Payer: Signature Care PPO |
$30.63
|
| Rate for Payer: Three Rivers Preferred All Products |
$27.00
|
| Rate for Payer: United Healthcare Commercial |
$34.33
|
| Rate for Payer: United Healthcare Medicare |
$17.27
|
|
|
PR XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS
|
Professional
|
$46.84
|
|
|
Service Code
|
CPT 93228
|
| Hospital Charge Code |
Z13080
|
| Min. Negotiated Rate |
$23.42 |
| Max. Negotiated Rate |
$56.21 |
| Rate for Payer: Aetna Medicare |
$24.01
|
| Rate for Payer: Anthem Exchange |
$24.28
|
| Rate for Payer: Anthem Medicare |
$24.01
|
| Rate for Payer: Anthem PPO |
$24.28
|
| Rate for Payer: Anthem Traditional |
$24.28
|
| Rate for Payer: Caresource Just 4 Me |
$27.61
|
| Rate for Payer: Caresource Medicare |
$26.41
|
| Rate for Payer: Centivo/Paragon All Products |
$37.22
|
| Rate for Payer: Coventry/First Health All Products |
$56.21
|
| Rate for Payer: Frontpath All Products |
$27.93
|
| Rate for Payer: Humana ChoiceCare |
$46.84
|
| Rate for Payer: Humana Medicare |
$24.01
|
| Rate for Payer: Lucent/Coldwater Veneers |
$40.82
|
| Rate for Payer: Lutheran Preferred All Products |
$38.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$35.13
|
| Rate for Payer: PHP All Products |
$34.43
|
| Rate for Payer: Plain Church Group Ministry All Products |
$24.01
|
| Rate for Payer: Signature Care EPO |
$37.97
|
| Rate for Payer: Signature Care PPO |
$37.97
|
| Rate for Payer: Three Rivers Preferred All Products |
$36.00
|
| Rate for Payer: United Healthcare Commercial |
$31.03
|
| Rate for Payer: United Healthcare Medicare |
$23.42
|
|
|
PR XTRNL MOBILE CV TELEMETRY W/TECHNICAL SUPPORT
|
Professional
|
$1,507.24
|
|
|
Service Code
|
CPT 93229
|
| Hospital Charge Code |
Z13081
|
| Min. Negotiated Rate |
$381.10 |
| Max. Negotiated Rate |
$1,808.69 |
| Rate for Payer: Aetna Medicare |
$772.46
|
| Rate for Payer: Anthem Exchange |
$679.15
|
| Rate for Payer: Anthem Medicare |
$772.46
|
| Rate for Payer: Anthem PPO |
$679.15
|
| Rate for Payer: Anthem Traditional |
$679.15
|
| Rate for Payer: Caresource Just 4 Me |
$888.33
|
| Rate for Payer: Caresource Medicare |
$849.71
|
| Rate for Payer: Centivo/Paragon All Products |
$1,197.31
|
| Rate for Payer: Coventry/First Health All Products |
$1,808.69
|
| Rate for Payer: Frontpath All Products |
$916.49
|
| Rate for Payer: Humana ChoiceCare |
$1,507.24
|
| Rate for Payer: Humana Medicare |
$772.46
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,313.18
|
| Rate for Payer: Lutheran Preferred All Products |
$1,236.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,130.43
|
| Rate for Payer: PHP All Products |
$1,107.83
|
| Rate for Payer: Plain Church Group Ministry All Products |
$772.46
|
| Rate for Payer: Signature Care EPO |
$1,157.58
|
| Rate for Payer: Signature Care PPO |
$1,157.58
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,159.00
|
| Rate for Payer: United Healthcare Commercial |
$381.10
|
| Rate for Payer: United Healthcare Medicare |
$753.62
|
|
|
PR XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS
|
Professional
|
$322.96
|
|
|
Service Code
|
CPT 93268
|
| Hospital Charge Code |
Z13088
|
| Min. Negotiated Rate |
$161.48 |
| Max. Negotiated Rate |
$387.55 |
| Rate for Payer: Aetna Medicare |
$165.52
|
| Rate for Payer: Anthem Exchange |
$205.17
|
| Rate for Payer: Anthem Medicare |
$165.52
|
| Rate for Payer: Anthem PPO |
$205.17
|
| Rate for Payer: Anthem Traditional |
$205.17
|
| Rate for Payer: Caresource Just 4 Me |
$190.35
|
| Rate for Payer: Caresource Medicare |
$182.07
|
| Rate for Payer: Centivo/Paragon All Products |
$256.56
|
| Rate for Payer: Coventry/First Health All Products |
$387.55
|
| Rate for Payer: Frontpath All Products |
$192.10
|
| Rate for Payer: Humana ChoiceCare |
$322.96
|
| Rate for Payer: Humana Medicare |
$165.52
|
| Rate for Payer: Lucent/Coldwater Veneers |
$281.38
|
| Rate for Payer: Lutheran Preferred All Products |
$265.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$242.22
|
| Rate for Payer: PHP All Products |
$237.38
|
| Rate for Payer: Plain Church Group Ministry All Products |
$165.52
|
| Rate for Payer: Signature Care EPO |
$291.65
|
| Rate for Payer: Signature Care PPO |
$291.65
|
| Rate for Payer: Three Rivers Preferred All Products |
$248.00
|
| Rate for Payer: United Healthcare Commercial |
$302.50
|
| Rate for Payer: United Healthcare Medicare |
$161.48
|
|
|
PR XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS
|
Professional
|
$45.26
|
|
|
Service Code
|
CPT 93272
|
| Hospital Charge Code |
Z13090
|
| Min. Negotiated Rate |
$22.63 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Medicare |
$23.19
|
| Rate for Payer: Anthem Exchange |
$23.55
|
| Rate for Payer: Anthem Medicare |
$23.19
|
| Rate for Payer: Anthem PPO |
$23.55
|
| Rate for Payer: Anthem Traditional |
$23.55
|
| Rate for Payer: Caresource Just 4 Me |
$26.67
|
| Rate for Payer: Caresource Medicare |
$25.51
|
| Rate for Payer: Centivo/Paragon All Products |
$35.94
|
| Rate for Payer: Coventry/First Health All Products |
$54.31
|
| Rate for Payer: Frontpath All Products |
$26.88
|
| Rate for Payer: Humana ChoiceCare |
$45.26
|
| Rate for Payer: Humana Medicare |
$23.19
|
| Rate for Payer: Lucent/Coldwater Veneers |
$39.42
|
| Rate for Payer: Lutheran Preferred All Products |
$37.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$33.95
|
| Rate for Payer: PHP All Products |
$33.26
|
| Rate for Payer: Plain Church Group Ministry All Products |
$23.19
|
| Rate for Payer: Signature Care EPO |
$40.66
|
| Rate for Payer: Signature Care PPO |
$40.66
|
| Rate for Payer: Three Rivers Preferred All Products |
$35.00
|
| Rate for Payer: United Healthcare Commercial |
$33.09
|
| Rate for Payer: United Healthcare Medicare |
$22.63
|
|
