|
PR BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL
|
Professional
|
Both
|
$4,825.00
|
|
|
Service Code
|
HCPCS 35654
|
| Min. Negotiated Rate |
$850.08 |
| Max. Negotiated Rate |
$3,377.50 |
| Rate for Payer: Aetna Commercial |
$1,798.90
|
| Rate for Payer: Aetna Medicare |
$1,396.16
|
| Rate for Payer: BCBS Complete |
$892.58
|
| Rate for Payer: BCBS MAPPO |
$1,342.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.11
|
| Rate for Payer: BCN Commercial |
$1,943.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,342.46
|
| Rate for Payer: Cash Price |
$3,860.00
|
| Rate for Payer: Cash Price |
$3,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,798.90
|
| Rate for Payer: Cofinity Commercial |
$1,933.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,342.46
|
| Rate for Payer: Mclaren Medicaid |
$850.08
|
| Rate for Payer: Meridian Medicaid |
$892.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,409.58
|
| Rate for Payer: PACE SWMI |
$1,342.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,342.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,377.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,115.59
|
| Rate for Payer: Priority Health Medicare |
$1,342.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,115.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,342.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,382.73
|
|
|
PR BYP OTH/THN VEIN CAROTID-SUBCLAVIAN
|
Professional
|
Both
|
$2,278.00
|
|
|
Service Code
|
HCPCS 35606
|
| Min. Negotiated Rate |
$733.79 |
| Max. Negotiated Rate |
$1,821.96 |
| Rate for Payer: Aetna Commercial |
$1,547.91
|
| Rate for Payer: Aetna Medicare |
$1,201.37
|
| Rate for Payer: BCBS Complete |
$770.48
|
| Rate for Payer: BCBS MAPPO |
$1,155.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,535.77
|
| Rate for Payer: BCN Commercial |
$1,673.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.16
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cofinity Commercial |
$1,547.91
|
| Rate for Payer: Cofinity Commercial |
$1,663.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.16
|
| Rate for Payer: Mclaren Medicaid |
$733.79
|
| Rate for Payer: Meridian Medicaid |
$770.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,212.92
|
| Rate for Payer: PACE SWMI |
$1,155.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,594.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,821.96
|
| Rate for Payer: Priority Health Medicare |
$1,155.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,821.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,155.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,189.81
|
|
|
PR BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID
|
Professional
|
Both
|
$2,884.00
|
|
|
Service Code
|
HCPCS 35601
|
| Min. Negotiated Rate |
$873.30 |
| Max. Negotiated Rate |
$2,177.30 |
| Rate for Payer: Aetna Commercial |
$1,851.88
|
| Rate for Payer: Aetna Medicare |
$1,437.28
|
| Rate for Payer: BCBS Complete |
$916.96
|
| Rate for Payer: BCBS MAPPO |
$1,382.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,268.45
|
| Rate for Payer: BCN Commercial |
$2,000.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,382.00
|
| Rate for Payer: Cash Price |
$2,307.20
|
| Rate for Payer: Cash Price |
$2,307.20
|
| Rate for Payer: Cofinity Commercial |
$1,990.08
|
| Rate for Payer: Cofinity Commercial |
$1,851.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,382.00
|
| Rate for Payer: Mclaren Medicaid |
$873.30
|
| Rate for Payer: Meridian Medicaid |
$916.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,451.10
|
| Rate for Payer: PACE SWMI |
$1,382.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,382.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$873.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,018.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,177.30
|
| Rate for Payer: Priority Health Medicare |
$1,382.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,177.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,382.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,382.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,423.46
|
|
|
PR BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL
|
Professional
|
Both
|
$4,125.00
|
|
|
Service Code
|
HCPCS 35666
|
| Min. Negotiated Rate |
$803.22 |
| Max. Negotiated Rate |
$2,887.50 |
| Rate for Payer: Aetna Commercial |
$1,724.92
|
| Rate for Payer: BCBS Complete |
$843.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.71
|
| Rate for Payer: BCN Commercial |
$1,839.87
|
| Rate for Payer: Cash Price |
$3,300.00
|
| Rate for Payer: Cash Price |
$3,300.00
|
| Rate for Payer: Mclaren Medicaid |
$803.22
|
| Rate for Payer: Meridian Medicaid |
$843.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$803.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,887.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,002.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,002.82
|
|
|
PR BYP OTH/THN VEIN FEMORAL-FEMORAL
|
Professional
|
Both
|
$2,209.00
|
|
|
Service Code
|
HCPCS 35661
|
| Min. Negotiated Rate |
$675.42 |
| Max. Negotiated Rate |
$1,683.11 |
| Rate for Payer: Aetna Commercial |
$1,427.89
|
| Rate for Payer: Aetna Medicare |
$1,108.21
|
| Rate for Payer: BCBS Complete |
$709.19
|
| Rate for Payer: BCBS MAPPO |
$1,065.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.54
|
| Rate for Payer: BCN Commercial |
$1,546.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,065.59
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cofinity Commercial |
$1,427.89
|
| Rate for Payer: Cofinity Commercial |
$1,534.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,065.59
|
| Rate for Payer: Mclaren Medicaid |
$675.42
|
| Rate for Payer: Meridian Medicaid |
$709.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,118.87
|
| Rate for Payer: PACE SWMI |
$1,065.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,065.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,546.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,683.11
|
| Rate for Payer: Priority Health Medicare |
$1,065.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,683.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,065.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,097.56
|
|
|
PR BYP OTH/THN VEIN FEMORAL-POPLITEAL
|
Professional
|
Both
|
$2,233.00
|
|
|
Service Code
|
HCPCS 35656
|
| Min. Negotiated Rate |
$668.82 |
| Max. Negotiated Rate |
$1,668.21 |
| Rate for Payer: Aetna Commercial |
$1,417.02
|
| Rate for Payer: Aetna Medicare |
$1,099.78
|
| Rate for Payer: BCBS Complete |
$702.26
|
| Rate for Payer: BCBS MAPPO |
$1,057.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,054.49
|
| Rate for Payer: BCN Commercial |
$1,532.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,057.48
|
| Rate for Payer: Cash Price |
$1,786.40
|
| Rate for Payer: Cash Price |
$1,786.40
|
| Rate for Payer: Cofinity Commercial |
$1,417.02
|
| Rate for Payer: Cofinity Commercial |
$1,522.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,057.48
|
| Rate for Payer: Mclaren Medicaid |
$668.82
|
| Rate for Payer: Meridian Medicaid |
$702.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,110.35
|
| Rate for Payer: PACE SWMI |
$1,057.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,057.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$668.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,563.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,668.21
|
| Rate for Payer: Priority Health Medicare |
$1,057.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,668.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,057.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,057.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,089.20
|
|
|
PR BYP OTH/THN VEIN ILIOFEMORAL
|
Professional
|
Both
|
$4,492.00
|
|
|
Service Code
|
HCPCS 35665
|
| Min. Negotiated Rate |
$732.29 |
| Max. Negotiated Rate |
$3,144.40 |
| Rate for Payer: Aetna Commercial |
$1,546.76
|
| Rate for Payer: Aetna Medicare |
$1,200.47
|
| Rate for Payer: BCBS Complete |
$768.90
|
| Rate for Payer: BCBS MAPPO |
$1,154.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.50
|
| Rate for Payer: BCN Commercial |
$1,673.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,154.30
|
| Rate for Payer: Cash Price |
$3,593.60
|
| Rate for Payer: Cash Price |
$3,593.60
|
| Rate for Payer: Cofinity Commercial |
$1,546.76
|
| Rate for Payer: Cofinity Commercial |
$1,662.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,154.30
|
| Rate for Payer: Mclaren Medicaid |
$732.29
|
| Rate for Payer: Meridian Medicaid |
$768.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,212.02
|
| Rate for Payer: PACE SWMI |
$1,154.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,154.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$732.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,144.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,821.43
|
| Rate for Payer: Priority Health Medicare |
$1,154.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,821.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,154.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,154.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,188.93
|
|
|
PR BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART
|
Professional
|
Both
|
$2,160.00
|
|
|
Service Code
|
HCPCS 35671
|
| Min. Negotiated Rate |
$707.16 |
| Max. Negotiated Rate |
$1,765.04 |
| Rate for Payer: Aetna Commercial |
$1,494.05
|
| Rate for Payer: Aetna Medicare |
$1,159.56
|
| Rate for Payer: BCBS Complete |
$742.52
|
| Rate for Payer: BCBS MAPPO |
$1,114.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,384.67
|
| Rate for Payer: BCN Commercial |
$1,621.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,114.96
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cofinity Commercial |
$1,605.54
|
| Rate for Payer: Cofinity Commercial |
$1,494.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,114.96
|
| Rate for Payer: Mclaren Medicaid |
$707.16
|
| Rate for Payer: Meridian Medicaid |
$742.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,170.71
|
| Rate for Payer: PACE SWMI |
$1,114.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,114.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$707.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,512.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,765.04
|
| Rate for Payer: Priority Health Medicare |
$1,114.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,765.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,114.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,114.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,148.41
|
|
|
PR BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 35612
|
| Min. Negotiated Rate |
$653.48 |
| Max. Negotiated Rate |
$2,601.35 |
| Rate for Payer: Aetna Commercial |
$1,381.79
|
| Rate for Payer: Aetna Medicare |
$1,072.44
|
| Rate for Payer: BCBS Complete |
$686.15
|
| Rate for Payer: BCBS MAPPO |
$1,031.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,601.35
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,031.19
|
| Rate for Payer: Cash Price |
$1,760.00
|
| Rate for Payer: Cash Price |
$1,760.00
|
| Rate for Payer: Cofinity Commercial |
$1,381.79
|
| Rate for Payer: Cofinity Commercial |
$1,484.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,031.19
|
| Rate for Payer: Mclaren Medicaid |
$653.48
|
| Rate for Payer: Meridian Medicaid |
$686.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,082.75
|
| Rate for Payer: PACE SWMI |
$1,031.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,031.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$653.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,540.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,623.54
|
| Rate for Payer: Priority Health Medicare |
$1,031.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,623.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,031.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,031.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,062.13
|
|
|
PR BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL
|
Professional
|
Both
|
$2,743.00
|
|
|
Service Code
|
HCPCS 35570
|
| Min. Negotiated Rate |
$919.73 |
| Max. Negotiated Rate |
$2,284.77 |
| Rate for Payer: Aetna Commercial |
$1,947.44
|
| Rate for Payer: Aetna Medicare |
$1,511.44
|
| Rate for Payer: BCBS Complete |
$965.72
|
| Rate for Payer: BCBS MAPPO |
$1,453.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCN Commercial |
$2,098.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,453.31
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cofinity Commercial |
$1,947.44
|
| Rate for Payer: Cofinity Commercial |
$2,092.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,453.31
|
| Rate for Payer: Mclaren Medicaid |
$919.73
|
| Rate for Payer: Meridian Medicaid |
$965.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,525.98
|
| Rate for Payer: PACE SWMI |
$1,453.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,453.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$919.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,920.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,284.77
|
| Rate for Payer: Priority Health Medicare |
$1,453.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,284.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,453.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,453.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,496.91
|
|
|
PR BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL
|
Professional
|
Both
|
$5,135.00
|
|
|
Service Code
|
HCPCS 35571
|
| Min. Negotiated Rate |
$824.95 |
| Max. Negotiated Rate |
$3,594.50 |
| Rate for Payer: Aetna Commercial |
$1,746.78
|
| Rate for Payer: Aetna Medicare |
$1,355.71
|
| Rate for Payer: BCBS Complete |
$866.20
|
| Rate for Payer: BCBS MAPPO |
$1,303.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,402.64
|
| Rate for Payer: BCN Commercial |
$1,886.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,303.57
|
| Rate for Payer: Cash Price |
$4,108.00
|
| Rate for Payer: Cash Price |
$4,108.00
|
| Rate for Payer: Cofinity Commercial |
$1,877.14
|
| Rate for Payer: Cofinity Commercial |
$1,746.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,303.57
|
| Rate for Payer: Mclaren Medicaid |
$824.95
|
| Rate for Payer: Meridian Medicaid |
$866.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,368.75
|
| Rate for Payer: PACE SWMI |
$1,303.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,303.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$824.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,594.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,053.88
|
| Rate for Payer: Priority Health Medicare |
$1,303.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,053.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,303.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,303.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,342.68
|
|
|
PR CABG W/ARTERIAL GRAFT FOUR/>ARTERIAL GRAFTS
|
Professional
|
Both
|
$5,394.00
|
|
|
Service Code
|
HCPCS 33536
|
| Min. Negotiated Rate |
$1,086.18 |
| Max. Negotiated Rate |
$4,101.39 |
| Rate for Payer: Aetna Commercial |
$3,468.62
|
| Rate for Payer: Aetna Medicare |
$2,692.06
|
| Rate for Payer: BCBS Complete |
$1,731.94
|
| Rate for Payer: BCBS MAPPO |
$2,588.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,086.18
|
| Rate for Payer: BCN Commercial |
$3,767.70
|
| Rate for Payer: BCN Medicare Advantage |
$2,588.52
|
| Rate for Payer: Cash Price |
$4,315.20
|
| Rate for Payer: Cash Price |
$4,315.20
|
| Rate for Payer: Cofinity Commercial |
$3,727.47
|
| Rate for Payer: Cofinity Commercial |
$3,468.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,588.52
|
| Rate for Payer: Mclaren Medicaid |
$1,649.47
|
| Rate for Payer: Meridian Medicaid |
$1,731.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,717.95
|
| Rate for Payer: PACE SWMI |
$2,588.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,588.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,649.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,775.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,101.39
|
| Rate for Payer: Priority Health Medicare |
$2,588.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,101.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,588.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,588.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,666.18
|
|
|
PR CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT
|
Professional
|
Both
|
$3,834.34
|
|
|
Service Code
|
HCPCS 33533
|
| Min. Negotiated Rate |
$1,173.42 |
| Max. Negotiated Rate |
$2,920.45 |
| Rate for Payer: Aetna Commercial |
$2,466.59
|
| Rate for Payer: Aetna Medicare |
$1,914.37
|
| Rate for Payer: BCBS Complete |
$1,232.09
|
| Rate for Payer: BCBS MAPPO |
$1,840.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.66
|
| Rate for Payer: BCN Commercial |
$2,682.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,840.74
|
| Rate for Payer: Cash Price |
$3,067.47
|
| Rate for Payer: Cash Price |
$3,067.47
|
| Rate for Payer: Cofinity Commercial |
$2,650.67
|
| Rate for Payer: Cofinity Commercial |
$2,466.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,840.74
|
| Rate for Payer: Mclaren Medicaid |
$1,173.42
|
| Rate for Payer: Meridian Medicaid |
$1,232.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,932.78
|
| Rate for Payer: PACE SWMI |
$1,840.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,840.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,173.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,684.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,920.45
|
| Rate for Payer: Priority Health Medicare |
$1,840.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,920.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,840.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,840.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,895.96
|
|
|
PR CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS
|
Professional
|
Both
|
$5,035.48
|
|
|
Service Code
|
HCPCS 33535
|
| Min. Negotiated Rate |
$1,100.98 |
| Max. Negotiated Rate |
$3,811.48 |
| Rate for Payer: Aetna Commercial |
$3,222.23
|
| Rate for Payer: Aetna Medicare |
$2,500.84
|
| Rate for Payer: BCBS Complete |
$1,607.37
|
| Rate for Payer: BCBS MAPPO |
$2,404.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.98
|
| Rate for Payer: BCN Commercial |
$3,501.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,404.65
|
| Rate for Payer: Cash Price |
$4,028.38
|
| Rate for Payer: Cash Price |
$4,028.38
|
| Rate for Payer: Cofinity Commercial |
$3,462.70
|
| Rate for Payer: Cofinity Commercial |
$3,222.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,404.65
|
| Rate for Payer: Mclaren Medicaid |
$1,530.83
|
| Rate for Payer: Meridian Medicaid |
$1,607.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,524.88
|
| Rate for Payer: PACE SWMI |
$2,404.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,404.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,530.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,524.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,811.48
|
| Rate for Payer: Priority Health Medicare |
$2,404.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,811.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,404.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,404.65
|
| Rate for Payer: UHC Medicare Advantage |
$2,476.79
|
|
|
PR CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS
|
Professional
|
Both
|
$4,511.60
|
|
|
Service Code
|
HCPCS 33534
|
| Min. Negotiated Rate |
$1,126.86 |
| Max. Negotiated Rate |
$3,427.93 |
| Rate for Payer: Aetna Commercial |
$2,896.34
|
| Rate for Payer: Aetna Medicare |
$2,247.91
|
| Rate for Payer: BCBS Complete |
$1,446.80
|
| Rate for Payer: BCBS MAPPO |
$2,161.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.86
|
| Rate for Payer: BCN Commercial |
$3,149.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,161.45
|
| Rate for Payer: Cash Price |
$3,609.28
|
| Rate for Payer: Cash Price |
$3,609.28
|
| Rate for Payer: Cofinity Commercial |
$3,112.49
|
| Rate for Payer: Cofinity Commercial |
$2,896.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,161.45
|
| Rate for Payer: Mclaren Medicaid |
$1,377.90
|
| Rate for Payer: Meridian Medicaid |
$1,446.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,269.52
|
| Rate for Payer: PACE SWMI |
$2,161.45
|
| Rate for Payer: PHP Medicare Advantage |
$2,161.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,377.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,158.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,427.93
|
| Rate for Payer: Priority Health Medicare |
$2,161.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,427.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,161.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,161.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,226.29
|
|
|
PR CALIBRATED MICROCAP TUBE
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS A4651
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna Commercial |
$0.03
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCN Commercial |
$1.86
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
|
|
PR CALORIC VESTIBULAR TEST, EACH IRRIGATION, WITH RECORDING
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 92543
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$13.30 |
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.30
|
|
|
PR CANALITH REPOSITIONING PROCEDURE
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 95992
|
| Min. Negotiated Rate |
$35.52 |
| Max. Negotiated Rate |
$189.13 |
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Medicare |
$36.94
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$35.52
|
| Rate for Payer: BCBS Trust/PPO |
$189.13
|
| Rate for Payer: BCN Commercial |
$63.04
|
| Rate for Payer: BCN Medicare Advantage |
$35.52
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$47.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.30
|
| Rate for Payer: PACE SWMI |
$35.52
|
| Rate for Payer: PHP Medicare Advantage |
$35.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.06
|
| Rate for Payer: Priority Health Medicare |
$35.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.52
|
| Rate for Payer: UHC Medicare Advantage |
$36.59
|
|
|
PR CANTHOPLASTY
|
Professional
|
Both
|
$1,124.00
|
|
|
Service Code
|
HCPCS 67950
|
| Min. Negotiated Rate |
$292.66 |
| Max. Negotiated Rate |
$2,419.61 |
| Rate for Payer: Aetna Commercial |
$591.19
|
| Rate for Payer: Aetna Medicare |
$458.84
|
| Rate for Payer: BCBS Complete |
$307.29
|
| Rate for Payer: BCBS MAPPO |
$441.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,419.61
|
| Rate for Payer: BCN Commercial |
$850.79
|
| Rate for Payer: BCN Medicare Advantage |
$441.19
|
| Rate for Payer: Cash Price |
$899.20
|
| Rate for Payer: Cash Price |
$899.20
|
| Rate for Payer: Cofinity Commercial |
$635.31
|
| Rate for Payer: Cofinity Commercial |
$591.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.19
|
| Rate for Payer: Mclaren Medicaid |
$292.66
|
| Rate for Payer: Meridian Medicaid |
$307.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$463.25
|
| Rate for Payer: PACE SWMI |
$441.19
|
| Rate for Payer: PHP Medicare Advantage |
$441.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$292.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$786.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.75
|
| Rate for Payer: Priority Health Medicare |
$441.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$796.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.19
|
| Rate for Payer: UHC Medicare Advantage |
$454.43
|
|
|
PR CANTHOTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 67715
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$523.55 |
| Rate for Payer: Aetna Commercial |
$139.27
|
| Rate for Payer: Aetna Medicare |
$108.09
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$103.93
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$388.50
|
| Rate for Payer: BCN Medicare Advantage |
$103.93
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$139.27
|
| Rate for Payer: Cofinity Commercial |
$149.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.93
|
| Rate for Payer: Mclaren Medicaid |
$68.37
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$109.13
|
| Rate for Payer: PACE SWMI |
$103.93
|
| Rate for Payer: PHP Medicare Advantage |
$103.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.92
|
| Rate for Payer: Priority Health Medicare |
$103.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.93
|
| Rate for Payer: UHC Medicare Advantage |
$107.05
|
|
|
PR CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC
|
Professional
|
Both
|
$4,705.00
|
|
|
Service Code
|
HCPCS 27036
|
| Min. Negotiated Rate |
$197.75 |
| Max. Negotiated Rate |
$3,293.50 |
| Rate for Payer: Aetna Commercial |
$1,343.06
|
| Rate for Payer: Aetna Medicare |
$1,042.37
|
| Rate for Payer: BCBS Complete |
$689.29
|
| Rate for Payer: BCBS MAPPO |
$1,002.28
|
| Rate for Payer: BCBS Trust/PPO |
$197.75
|
| Rate for Payer: BCN Commercial |
$1,492.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,002.28
|
| Rate for Payer: Cash Price |
$3,764.00
|
| Rate for Payer: Cash Price |
$3,764.00
|
| Rate for Payer: Cofinity Commercial |
$1,443.28
|
| Rate for Payer: Cofinity Commercial |
$1,343.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,002.28
|
| Rate for Payer: Mclaren Medicaid |
$656.47
|
| Rate for Payer: Meridian Medicaid |
$689.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,052.39
|
| Rate for Payer: PACE SWMI |
$1,002.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,002.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$656.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,293.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,559.53
|
| Rate for Payer: Priority Health Medicare |
$1,002.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,559.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,002.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,002.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,032.35
|
|
|
PR CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS
|
Professional
|
Both
|
$1,721.00
|
|
|
Service Code
|
HCPCS 25320
|
| Min. Negotiated Rate |
$400.98 |
| Max. Negotiated Rate |
$1,520.20 |
| Rate for Payer: Aetna Commercial |
$1,300.72
|
| Rate for Payer: Aetna Medicare |
$1,009.52
|
| Rate for Payer: BCBS Complete |
$673.86
|
| Rate for Payer: BCBS MAPPO |
$970.69
|
| Rate for Payer: BCBS Trust/PPO |
$400.98
|
| Rate for Payer: BCN Commercial |
$1,454.79
|
| Rate for Payer: BCN Medicare Advantage |
$970.69
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,397.79
|
| Rate for Payer: Cofinity Commercial |
$1,300.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$970.69
|
| Rate for Payer: Mclaren Medicaid |
$641.77
|
| Rate for Payer: Meridian Medicaid |
$673.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,019.22
|
| Rate for Payer: PACE SWMI |
$970.69
|
| Rate for Payer: PHP Medicare Advantage |
$970.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,520.20
|
| Rate for Payer: Priority Health Medicare |
$970.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$970.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$970.69
|
| Rate for Payer: UHC Medicare Advantage |
$999.81
|
|
|
PR CAPSULAR CONTRACTURE RELEASE
|
Professional
|
Both
|
$1,971.00
|
|
|
Service Code
|
HCPCS 23020
|
| Min. Negotiated Rate |
$282.11 |
| Max. Negotiated Rate |
$1,379.70 |
| Rate for Payer: Aetna Commercial |
$913.37
|
| Rate for Payer: Aetna Medicare |
$708.88
|
| Rate for Payer: BCBS Complete |
$469.66
|
| Rate for Payer: BCBS MAPPO |
$681.62
|
| Rate for Payer: BCBS Trust/PPO |
$282.11
|
| Rate for Payer: BCN Commercial |
$1,017.92
|
| Rate for Payer: BCN Medicare Advantage |
$681.62
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cofinity Commercial |
$913.37
|
| Rate for Payer: Cofinity Commercial |
$981.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.62
|
| Rate for Payer: Mclaren Medicaid |
$447.30
|
| Rate for Payer: Meridian Medicaid |
$469.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$715.70
|
| Rate for Payer: PACE SWMI |
$681.62
|
| Rate for Payer: PHP Medicare Advantage |
$681.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,063.68
|
| Rate for Payer: Priority Health Medicare |
$681.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,063.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$681.62
|
| Rate for Payer: UHC Medicare Advantage |
$702.07
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 26525
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$1,128.45 |
| Rate for Payer: Aetna Commercial |
$894.87
|
| Rate for Payer: Aetna Medicare |
$694.52
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCBS MAPPO |
$667.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.45
|
| Rate for Payer: BCN Commercial |
$1,021.83
|
| Rate for Payer: BCN Medicare Advantage |
$667.81
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$894.87
|
| Rate for Payer: Cofinity Commercial |
$961.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.81
|
| Rate for Payer: Mclaren Medicaid |
$444.11
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$701.20
|
| Rate for Payer: PACE SWMI |
$667.81
|
| Rate for Payer: PHP Medicare Advantage |
$667.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,067.77
|
| Rate for Payer: Priority Health Medicare |
$667.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,067.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$667.81
|
| Rate for Payer: UHC Medicare Advantage |
$687.84
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 26520
|
| Min. Negotiated Rate |
$441.55 |
| Max. Negotiated Rate |
$1,088.50 |
| Rate for Payer: Aetna Commercial |
$890.87
|
| Rate for Payer: Aetna Medicare |
$691.42
|
| Rate for Payer: BCBS Complete |
$463.63
|
| Rate for Payer: BCBS MAPPO |
$664.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.94
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$664.83
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$957.36
|
| Rate for Payer: Cofinity Commercial |
$890.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$664.83
|
| Rate for Payer: Mclaren Medicaid |
$441.55
|
| Rate for Payer: Meridian Medicaid |
$463.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$698.07
|
| Rate for Payer: PACE SWMI |
$664.83
|
| Rate for Payer: PHP Medicare Advantage |
$664.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,063.17
|
| Rate for Payer: Priority Health Medicare |
$664.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,063.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$664.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$664.83
|
| Rate for Payer: UHC Medicare Advantage |
$684.77
|
|
