PR ANES PERMANENT TRANSVENOUS PACEMAKER INSERTION
|
Professional
|
Both
|
$4.00
|
|
Service Code
|
HCPCS 00530
|
Min. Negotiated Rate |
$1.60 |
Max. Negotiated Rate |
$2.80 |
Rate for Payer: BCBS Complete |
$1.60
|
Rate for Payer: Cash Price |
$3.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
|
PR ANES PERQ IMG NJX DRG/ASPIR PX SPI/SP CRV/THRC
|
Professional
|
Both
|
$338.00
|
|
Service Code
|
HCPCS 01937
|
Min. Negotiated Rate |
$135.20 |
Max. Negotiated Rate |
$236.60 |
Rate for Payer: BCBS Complete |
$135.20
|
Rate for Payer: Cash Price |
$270.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$236.60
|
|
PR ANES RAD AMP PENIS W/BI INGUINAL LYMPH NODE RMVL
|
Professional
|
Both
|
$6.00
|
|
Service Code
|
HCPCS 00934
|
Min. Negotiated Rate |
$2.40 |
Max. Negotiated Rate |
$4.20 |
Rate for Payer: BCBS Complete |
$2.40
|
Rate for Payer: Cash Price |
$4.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
|
PR ANES RAD AMP PENIS W/BI INGUNL&ILIAC LYMPH RMOVL
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS 00936
|
Min. Negotiated Rate |
$3.20 |
Max. Negotiated Rate |
$5.60 |
Rate for Payer: BCBS Complete |
$3.20
|
Rate for Payer: Cash Price |
$6.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
|
PR ANES RADICAL/MODIFIED RADICAL BREAST W/NODES
|
Professional
|
Both
|
$13.00
|
|
Service Code
|
HCPCS 00406
|
Min. Negotiated Rate |
$5.20 |
Max. Negotiated Rate |
$9.10 |
Rate for Payer: BCBS Complete |
$5.20
|
Rate for Payer: Cash Price |
$10.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
|
PR ANES RADICAL RESECJ INCL BELOW KNEE AMPUTATION
|
Professional
|
Both
|
$4.00
|
|
Service Code
|
HCPCS 01482
|
Min. Negotiated Rate |
$1.60 |
Max. Negotiated Rate |
$2.80 |
Rate for Payer: BCBS Complete |
$1.60
|
Rate for Payer: Cash Price |
$3.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
|
PR ANES RADICAL TUMOR PELVIS XCP HINDQUARTER AMP
|
Professional
|
Both
|
$10.00
|
|
Service Code
|
HCPCS 01150
|
Min. Negotiated Rate |
$4.00 |
Max. Negotiated Rate |
$7.00 |
Rate for Payer: BCBS Complete |
$4.00
|
Rate for Payer: Cash Price |
$8.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$7.00
|
|
PR ANES RADIUS ULNA WRIST/HAND BONES CLOSED PX
|
Professional
|
Both
|
$3.00
|
|
Service Code
|
HCPCS 01820
|
Min. Negotiated Rate |
$1.20 |
Max. Negotiated Rate |
$2.10 |
Rate for Payer: BCBS Complete |
$1.20
|
Rate for Payer: Cash Price |
$2.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.10
|
|
PR ANES RAD ORCHIECTOMY ABDOMINAL INCL OPN URTL
|
Professional
|
Both
|
$6.00
|
|
Service Code
|
HCPCS 00928
|
Min. Negotiated Rate |
$2.40 |
Max. Negotiated Rate |
$4.20 |
Rate for Payer: BCBS Complete |
$2.40
|
Rate for Payer: Cash Price |
$4.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
|
PR ANES RAD ORCHIECTOMY INGUN INCL OPEN URTL PX
|
Professional
|
Both
|
$4.00
|
|
Service Code
|
HCPCS 00926
|
Min. Negotiated Rate |
$1.60 |
Max. Negotiated Rate |
$2.80 |
Rate for Payer: BCBS Complete |
$1.60
|
Rate for Payer: Cash Price |
$3.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
|
PR ANES RPR RUPTURED ACHILLES TENDON W/WO GRAFT
|
Professional
|
Both
|
$5.00
|
|
Service Code
|
HCPCS 01472
|
Min. Negotiated Rate |
$2.00 |
Max. Negotiated Rate |
$3.50 |
Rate for Payer: BCBS Complete |
$2.00
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$3.50
|
|
PR ANES SEMINAL VESICLES INCL OPEN URETHRAL PX
|
Professional
|
Both
|
$6.00
|
|
Service Code
|
HCPCS 00922
|
Min. Negotiated Rate |
$2.40 |
Max. Negotiated Rate |
$4.20 |
Rate for Payer: BCBS Complete |
$2.40
|
Rate for Payer: Cash Price |
$4.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
|
PR ANES SHOULDER CAST APPL REMOVAL/REPAIR NOS
|
Professional
|
Both
|
$3.00
|
|
Service Code
|
HCPCS 01680
|
Min. Negotiated Rate |
$1.20 |
Max. Negotiated Rate |
$2.10 |
Rate for Payer: BCBS Complete |
$1.20
|
Rate for Payer: Cash Price |
$2.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.10
|
|
PR ANESTH,ABORTION PROC
|
Professional
|
Both
|
$4.00
|
|
Service Code
|
HCPCS 01964
|
Min. Negotiated Rate |
$1.60 |
Max. Negotiated Rate |
$2.80 |
Rate for Payer: BCBS Complete |
$1.60
|
Rate for Payer: Cash Price |
$3.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
|
PR ANESTH DIAGNOSTIC ARTHROSCOPIC PROC KNEE JOINT
|
Professional
|
Both
|
$3.00
|
|
Service Code
|
HCPCS 01382
|
Min. Negotiated Rate |
$1.20 |
Max. Negotiated Rate |
$2.10 |
Rate for Payer: BCBS Complete |
$1.20
|
Rate for Payer: Cash Price |
$2.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.10
|
|
PR ANESTHESIA ACCESS CENTRAL VENOUS CIRCULATION
|
Professional
|
Both
|
$4.00
|
|
Service Code
|
HCPCS 00532
|
Min. Negotiated Rate |
$1.60 |
Max. Negotiated Rate |
$2.80 |
Rate for Payer: BCBS Complete |
$1.60
|
Rate for Payer: Cash Price |
$3.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
|
PR ANESTHESIA ANORECTAL PROCEDURE
|
Professional
|
Both
|
$5.00
|
|
Service Code
|
HCPCS 00902
|
Min. Negotiated Rate |
$2.00 |
Max. Negotiated Rate |
$3.50 |
Rate for Payer: BCBS Complete |
$2.00
|
Rate for Payer: Cash Price |
$4.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$3.50
|
|
PR ANESTHESIA ARTERIES FOREARM WRIST & HAND NOS
|
Professional
|
Both
|
$6.00
|
|
Service Code
|
HCPCS 01840
|
Min. Negotiated Rate |
$2.40 |
Max. Negotiated Rate |
$4.20 |
Rate for Payer: BCBS Complete |
$2.40
|
Rate for Payer: Cash Price |
$4.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
|
PR ANESTHESIA ARTERIES LOWER LEG W/BYPASS GRAFT NOS
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS 01500
|
Min. Negotiated Rate |
$3.20 |
Max. Negotiated Rate |
$5.60 |
Rate for Payer: BCBS Complete |
$3.20
|
Rate for Payer: Cash Price |
$6.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
|
PR ANESTHESIA ARTERIES SHOULDER & AXILLA NOS
|
Professional
|
Both
|
$6.00
|
|
Service Code
|
HCPCS 01650
|
Min. Negotiated Rate |
$2.40 |
Max. Negotiated Rate |
$4.20 |
Rate for Payer: BCBS Complete |
$2.40
|
Rate for Payer: Cash Price |
$4.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
|
PR ANESTHESIA ARTERIES UPPER ARM&ELBOW EMBOLECTOM
|
Professional
|
Both
|
$6.00
|
|
Service Code
|
HCPCS 01772
|
Min. Negotiated Rate |
$2.40 |
Max. Negotiated Rate |
$4.20 |
Rate for Payer: BCBS Complete |
$2.40
|
Rate for Payer: Cash Price |
$4.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
|
PR ANESTHESIA ARTERIES UPPER ARM & ELBOW NOS
|
Professional
|
Both
|
$6.00
|
|
Service Code
|
HCPCS 01770
|
Min. Negotiated Rate |
$2.40 |
Max. Negotiated Rate |
$4.20 |
Rate for Payer: BCBS Complete |
$2.40
|
Rate for Payer: Cash Price |
$4.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
|
PR ANESTHESIA ARTERIES UPPER LEG INCL BYPASS GRAFT
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS 01270
|
Min. Negotiated Rate |
$3.20 |
Max. Negotiated Rate |
$5.60 |
Rate for Payer: BCBS Complete |
$3.20
|
Rate for Payer: Cash Price |
$6.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
|
PR ANESTHESIA ARTHROSCOPIC HIP JOINT PROCEDURE
|
Professional
|
Both
|
$4.00
|
|
Service Code
|
HCPCS 01202
|
Min. Negotiated Rate |
$1.60 |
Max. Negotiated Rate |
$2.80 |
Rate for Payer: BCBS Complete |
$1.60
|
Rate for Payer: Cash Price |
$3.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
|
PR ANESTHESIA ARTHROSCOPIC PROCEDURE ANKLE & FOOT
|
Professional
|
Both
|
$3.00
|
|
Service Code
|
HCPCS 01464
|
Min. Negotiated Rate |
$1.20 |
Max. Negotiated Rate |
$2.10 |
Rate for Payer: BCBS Complete |
$1.20
|
Rate for Payer: Cash Price |
$2.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.10
|
|