Fee Schedule Lookup
  Fee Schedule Search
* Indicates Required Field
*Corporate Tax ID Owner:  
*Physician/Provider Tax ID:    
*Physician/Provider Name:  
*Provider Zip Code:  
*Are you the PCP/Acting PCP for this service? Yes No
*Is service related to Mental Health? Yes No
Member Information look-up   (Please select to locate the member to populate the fields below)
*Member Zip Code:   *Date of Birth: (mm/dd/yyyy)   *Gender: Female Male
*Place of Service:  
*Date to Check: (mm/dd/yyyy)  
Diagnosis Code:  
(If a diagnosis modifier is applicable, it should be supplied)
*Enter CPT (Common Procedural Terminology) or HCPC (HCFA Common Procedural Code)

NOTE: The Fee Schedule shown is not a guarantee of benefits, payments or clinical coverage determination. Actual payment for services and the amount(s) to be paid are determined by your participation agreement with us and the enrollee's benefit plan at the time services are provided. Fee Schedule Look-Up is not available for non-participating providers. If you believe that your fee schedule is incorrect or have any other questions regarding your contracted rate, please contact your Network Provider Representative.
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