|
PR DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY
|
Professional
|
Both
|
$331.00
|
|
|
Service Code
|
HCPCS 46930
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$1,115.77 |
| Rate for Payer: Aetna Commercial |
$195.96
|
| Rate for Payer: Aetna Medicare |
$152.09
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$146.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,115.77
|
| Rate for Payer: BCN Commercial |
$255.24
|
| Rate for Payer: BCN Medicare Advantage |
$146.24
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cofinity Commercial |
$195.96
|
| Rate for Payer: Cofinity Commercial |
$210.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.24
|
| Rate for Payer: Mclaren Medicaid |
$97.55
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$153.55
|
| Rate for Payer: PACE SWMI |
$146.24
|
| Rate for Payer: PHP Medicare Advantage |
$146.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.94
|
| Rate for Payer: Priority Health Medicare |
$146.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.24
|
| Rate for Payer: UHC Medicare Advantage |
$150.63
|
|
|
PR DESTRUCTION LESION LID MARGIN </ 1 CM
|
Professional
|
Both
|
$477.00
|
|
|
Service Code
|
HCPCS 67850
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$347.09 |
| Rate for Payer: Aetna Commercial |
$169.23
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$347.09
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cofinity Commercial |
$181.86
|
| Rate for Payer: Cofinity Commercial |
$169.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Mclaren Medicaid |
$83.28
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.73
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Medicare Advantage |
$130.08
|
|
|
PR DESTRUCTION LESIONS VULVA EXTENSIVE
|
Professional
|
Both
|
$569.00
|
|
|
Service Code
|
HCPCS 56515
|
| Min. Negotiated Rate |
$136.96 |
| Max. Negotiated Rate |
$2,047.16 |
| Rate for Payer: Aetna Commercial |
$280.94
|
| Rate for Payer: Aetna Medicare |
$218.05
|
| Rate for Payer: BCBS Complete |
$143.81
|
| Rate for Payer: BCBS MAPPO |
$209.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,047.16
|
| Rate for Payer: BCN Commercial |
$409.52
|
| Rate for Payer: BCN Medicare Advantage |
$209.66
|
| Rate for Payer: Cash Price |
$455.20
|
| Rate for Payer: Cash Price |
$455.20
|
| Rate for Payer: Cofinity Commercial |
$280.94
|
| Rate for Payer: Cofinity Commercial |
$301.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.66
|
| Rate for Payer: Mclaren Medicaid |
$136.96
|
| Rate for Payer: Meridian Medicaid |
$143.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.14
|
| Rate for Payer: PACE SWMI |
$209.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$302.99
|
| Rate for Payer: Priority Health Medicare |
$209.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$302.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.66
|
| Rate for Payer: UHC Medicare Advantage |
$215.95
|
|
|
PR DESTRUCTION LESIONS VULVA SIMPLE
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 56501
|
| Min. Negotiated Rate |
$86.27 |
| Max. Negotiated Rate |
$1,962.11 |
| Rate for Payer: Aetna Commercial |
$174.96
|
| Rate for Payer: Aetna Medicare |
$135.79
|
| Rate for Payer: BCBS Complete |
$90.58
|
| Rate for Payer: BCBS MAPPO |
$130.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,962.11
|
| Rate for Payer: BCN Commercial |
$229.32
|
| Rate for Payer: BCN Medicare Advantage |
$130.57
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Commercial |
$188.02
|
| Rate for Payer: Cofinity Commercial |
$174.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.57
|
| Rate for Payer: Mclaren Medicaid |
$86.27
|
| Rate for Payer: Meridian Medicaid |
$90.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.10
|
| Rate for Payer: PACE SWMI |
$130.57
|
| Rate for Payer: PHP Medicare Advantage |
$130.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.80
|
| Rate for Payer: Priority Health Medicare |
$130.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.57
|
| Rate for Payer: UHC Medicare Advantage |
$134.49
|
|
|
PR DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<
|
Professional
|
Both
|
$229.00
|
|
|
Service Code
|
HCPCS 17280
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$3,247.68 |
| Rate for Payer: Aetna Commercial |
$111.73
|
| Rate for Payer: Aetna Medicare |
$86.72
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$83.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,247.68
|
| Rate for Payer: BCN Commercial |
$164.92
|
| Rate for Payer: BCN Medicare Advantage |
$83.38
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cofinity Commercial |
$111.73
|
| Rate for Payer: Cofinity Commercial |
$120.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.38
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.55
|
| Rate for Payer: PACE SWMI |
$83.38
|
| Rate for Payer: PHP Medicare Advantage |
$83.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.22
|
| Rate for Payer: Priority Health Medicare |
$83.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.38
|
| Rate for Payer: UHC Medicare Advantage |
$85.88
|
|
|
PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 17270
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$3,247.68 |
| Rate for Payer: Aetna Commercial |
$124.30
|
| Rate for Payer: Aetna Medicare |
$96.47
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$92.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,247.68
|
| Rate for Payer: BCN Commercial |
$176.70
|
| Rate for Payer: BCN Medicare Advantage |
$92.76
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$124.30
|
| Rate for Payer: Cofinity Commercial |
$133.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.76
|
| Rate for Payer: Mclaren Medicaid |
$61.13
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.40
|
| Rate for Payer: PACE SWMI |
$92.76
|
| Rate for Payer: PHP Medicare Advantage |
$92.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.74
|
| Rate for Payer: Priority Health Medicare |
$92.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.76
|
| Rate for Payer: UHC Medicare Advantage |
$95.54
|
|
|
PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 17271
|
| Min. Negotiated Rate |
$67.10 |
| Max. Negotiated Rate |
$5,054.50 |
| Rate for Payer: Aetna Commercial |
$136.97
|
| Rate for Payer: Aetna Medicare |
$106.31
|
| Rate for Payer: BCBS Complete |
$70.46
|
| Rate for Payer: BCBS MAPPO |
$102.22
|
| Rate for Payer: BCBS Trust/PPO |
$5,054.50
|
| Rate for Payer: BCN Commercial |
$196.33
|
| Rate for Payer: BCN Medicare Advantage |
$102.22
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$136.97
|
| Rate for Payer: Cofinity Commercial |
$147.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.22
|
| Rate for Payer: Mclaren Medicaid |
$67.10
|
| Rate for Payer: Meridian Medicaid |
$70.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.33
|
| Rate for Payer: PACE SWMI |
$102.22
|
| Rate for Payer: PHP Medicare Advantage |
$102.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.66
|
| Rate for Payer: Priority Health Medicare |
$102.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.22
|
| Rate for Payer: UHC Medicare Advantage |
$105.29
|
|
|
PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 17272
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$29,358.48 |
| Rate for Payer: Aetna Commercial |
$157.29
|
| Rate for Payer: Aetna Medicare |
$122.08
|
| Rate for Payer: BCBS Complete |
$81.19
|
| Rate for Payer: BCBS MAPPO |
$117.38
|
| Rate for Payer: BCBS Trust/PPO |
$29,358.48
|
| Rate for Payer: BCN Commercial |
$222.25
|
| Rate for Payer: BCN Medicare Advantage |
$117.38
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cofinity Commercial |
$157.29
|
| Rate for Payer: Cofinity Commercial |
$169.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.38
|
| Rate for Payer: Mclaren Medicaid |
$77.32
|
| Rate for Payer: Meridian Medicaid |
$81.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.25
|
| Rate for Payer: PACE SWMI |
$117.38
|
| Rate for Payer: PHP Medicare Advantage |
$117.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.57
|
| Rate for Payer: Priority Health Medicare |
$117.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.38
|
| Rate for Payer: UHC Medicare Advantage |
$120.90
|
|
|
PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$337.00
|
|
|
Service Code
|
HCPCS 17273
|
| Min. Negotiated Rate |
$87.33 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$178.09
|
| Rate for Payer: Aetna Medicare |
$138.22
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS MAPPO |
$132.90
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$246.20
|
| Rate for Payer: BCN Medicare Advantage |
$132.90
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cofinity Commercial |
$191.38
|
| Rate for Payer: Cofinity Commercial |
$178.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.90
|
| Rate for Payer: Mclaren Medicaid |
$87.33
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$139.54
|
| Rate for Payer: PACE SWMI |
$132.90
|
| Rate for Payer: PHP Medicare Advantage |
$132.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.88
|
| Rate for Payer: Priority Health Medicare |
$132.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.90
|
| Rate for Payer: UHC Medicare Advantage |
$136.89
|
|
|
PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM
|
Professional
|
Both
|
$425.00
|
|
|
Service Code
|
HCPCS 17274
|
| Min. Negotiated Rate |
$106.50 |
| Max. Negotiated Rate |
$6,178.65 |
| Rate for Payer: Aetna Commercial |
$218.29
|
| Rate for Payer: Aetna Medicare |
$169.42
|
| Rate for Payer: BCBS Complete |
$111.82
|
| Rate for Payer: BCBS MAPPO |
$162.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,178.65
|
| Rate for Payer: BCN Commercial |
$288.21
|
| Rate for Payer: BCN Medicare Advantage |
$162.90
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cofinity Commercial |
$234.58
|
| Rate for Payer: Cofinity Commercial |
$218.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.90
|
| Rate for Payer: Mclaren Medicaid |
$106.50
|
| Rate for Payer: Meridian Medicaid |
$111.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.04
|
| Rate for Payer: PACE SWMI |
$162.90
|
| Rate for Payer: PHP Medicare Advantage |
$162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.29
|
| Rate for Payer: Priority Health Medicare |
$162.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.90
|
| Rate for Payer: UHC Medicare Advantage |
$167.79
|
|
|
PR DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<
|
Professional
|
Both
|
$165.00
|
|
|
Service Code
|
HCPCS 17260
|
| Min. Negotiated Rate |
$45.16 |
| Max. Negotiated Rate |
$947.65 |
| Rate for Payer: Aetna Commercial |
$91.50
|
| Rate for Payer: Aetna Medicare |
$71.01
|
| Rate for Payer: BCBS Complete |
$47.42
|
| Rate for Payer: BCBS MAPPO |
$68.28
|
| Rate for Payer: BCBS Trust/PPO |
$947.65
|
| Rate for Payer: BCN Commercial |
$117.80
|
| Rate for Payer: BCN Medicare Advantage |
$68.28
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cofinity Commercial |
$98.32
|
| Rate for Payer: Cofinity Commercial |
$91.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.28
|
| Rate for Payer: Mclaren Medicaid |
$45.16
|
| Rate for Payer: Meridian Medicaid |
$47.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.69
|
| Rate for Payer: PACE SWMI |
$68.28
|
| Rate for Payer: PHP Medicare Advantage |
$68.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.31
|
| Rate for Payer: Priority Health Medicare |
$68.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.28
|
| Rate for Payer: UHC Medicare Advantage |
$70.33
|
|
|
PR DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 17281
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$153.78
|
| Rate for Payer: Aetna Medicare |
$119.35
|
| Rate for Payer: BCBS Complete |
$79.17
|
| Rate for Payer: BCBS MAPPO |
$114.76
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$212.04
|
| Rate for Payer: BCN Medicare Advantage |
$114.76
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cofinity Commercial |
$165.25
|
| Rate for Payer: Cofinity Commercial |
$153.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.76
|
| Rate for Payer: Mclaren Medicaid |
$75.40
|
| Rate for Payer: Meridian Medicaid |
$79.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.50
|
| Rate for Payer: PACE SWMI |
$114.76
|
| Rate for Payer: PHP Medicare Advantage |
$114.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.27
|
| Rate for Payer: Priority Health Medicare |
$114.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.76
|
| Rate for Payer: UHC Medicare Advantage |
$118.20
|
|
|
PR DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM
|
Professional
|
Both
|
$331.00
|
|
|
Service Code
|
HCPCS 17282
|
| Min. Negotiated Rate |
$86.90 |
| Max. Negotiated Rate |
$3,247.68 |
| Rate for Payer: Aetna Commercial |
$177.63
|
| Rate for Payer: Aetna Medicare |
$137.86
|
| Rate for Payer: BCBS Complete |
$91.24
|
| Rate for Payer: BCBS MAPPO |
$132.56
|
| Rate for Payer: BCBS Trust/PPO |
$3,247.68
|
| Rate for Payer: BCN Commercial |
$242.28
|
| Rate for Payer: BCN Medicare Advantage |
$132.56
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cofinity Commercial |
$177.63
|
| Rate for Payer: Cofinity Commercial |
$190.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.56
|
| Rate for Payer: Mclaren Medicaid |
$86.90
|
| Rate for Payer: Meridian Medicaid |
$91.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$139.19
|
| Rate for Payer: PACE SWMI |
$132.56
|
| Rate for Payer: PHP Medicare Advantage |
$132.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.47
|
| Rate for Payer: Priority Health Medicare |
$132.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.56
|
| Rate for Payer: UHC Medicare Advantage |
$136.54
|
|
|
PR DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM
|
Professional
|
Both
|
$396.00
|
|
|
Service Code
|
HCPCS 17283
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$221.38
|
| Rate for Payer: Aetna Medicare |
$171.82
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$165.21
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$285.86
|
| Rate for Payer: BCN Medicare Advantage |
$165.21
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cofinity Commercial |
$221.38
|
| Rate for Payer: Cofinity Commercial |
$237.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.21
|
| Rate for Payer: Mclaren Medicaid |
$108.63
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$173.47
|
| Rate for Payer: PACE SWMI |
$165.21
|
| Rate for Payer: PHP Medicare Advantage |
$165.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.16
|
| Rate for Payer: Priority Health Medicare |
$165.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.21
|
| Rate for Payer: UHC Medicare Advantage |
$170.17
|
|
|
PR DESTRUCTION MAL LESION F/E/E/N/L/M 3.1-4.0CM
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 17284
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$325.13 |
| Rate for Payer: Aetna Commercial |
$259.13
|
| Rate for Payer: Aetna Medicare |
$201.12
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$193.38
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$325.13
|
| Rate for Payer: BCN Medicare Advantage |
$193.38
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cofinity Commercial |
$278.47
|
| Rate for Payer: Cofinity Commercial |
$259.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.38
|
| Rate for Payer: Mclaren Medicaid |
$126.31
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$203.05
|
| Rate for Payer: PACE SWMI |
$193.38
|
| Rate for Payer: PHP Medicare Advantage |
$193.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.11
|
| Rate for Payer: Priority Health Medicare |
$193.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.38
|
| Rate for Payer: UHC Medicare Advantage |
$199.18
|
|
|
PR DESTRUCTION MAL LESION F/E/E/N/L/M >4.0 CM
|
Professional
|
Both
|
$2,750.00
|
|
|
Service Code
|
HCPCS 17286
|
| Min. Negotiated Rate |
$171.47 |
| Max. Negotiated Rate |
$1,925.00 |
| Rate for Payer: Aetna Commercial |
$350.42
|
| Rate for Payer: Aetna Medicare |
$271.97
|
| Rate for Payer: BCBS Complete |
$180.04
|
| Rate for Payer: BCBS MAPPO |
$261.51
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$415.44
|
| Rate for Payer: BCN Medicare Advantage |
$261.51
|
| Rate for Payer: Cash Price |
$2,200.00
|
| Rate for Payer: Cash Price |
$2,200.00
|
| Rate for Payer: Cofinity Commercial |
$376.57
|
| Rate for Payer: Cofinity Commercial |
$350.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.51
|
| Rate for Payer: Mclaren Medicaid |
$171.47
|
| Rate for Payer: Meridian Medicaid |
$180.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$274.59
|
| Rate for Payer: PACE SWMI |
$261.51
|
| Rate for Payer: PHP Medicare Advantage |
$261.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.77
|
| Rate for Payer: Priority Health Medicare |
$261.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$261.51
|
| Rate for Payer: UHC Medicare Advantage |
$269.36
|
|
|
PR DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 17261
|
| Min. Negotiated Rate |
$55.81 |
| Max. Negotiated Rate |
$4,160.00 |
| Rate for Payer: Aetna Commercial |
$112.14
|
| Rate for Payer: Aetna Medicare |
$87.04
|
| Rate for Payer: BCBS Complete |
$58.60
|
| Rate for Payer: BCBS MAPPO |
$83.69
|
| Rate for Payer: BCBS Trust/PPO |
$4,160.00
|
| Rate for Payer: BCN Commercial |
$174.34
|
| Rate for Payer: BCN Medicare Advantage |
$83.69
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cofinity Commercial |
$120.51
|
| Rate for Payer: Cofinity Commercial |
$112.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.69
|
| Rate for Payer: Mclaren Medicaid |
$55.81
|
| Rate for Payer: Meridian Medicaid |
$58.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.87
|
| Rate for Payer: PACE SWMI |
$83.69
|
| Rate for Payer: PHP Medicare Advantage |
$83.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.64
|
| Rate for Payer: Priority Health Medicare |
$83.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.69
|
| Rate for Payer: UHC Medicare Advantage |
$86.20
|
|
|
PR DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 17262
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$4,106.85 |
| Rate for Payer: Aetna Commercial |
$143.62
|
| Rate for Payer: Aetna Medicare |
$111.47
|
| Rate for Payer: BCBS Complete |
$74.02
|
| Rate for Payer: BCBS MAPPO |
$107.18
|
| Rate for Payer: BCBS Trust/PPO |
$4,106.85
|
| Rate for Payer: BCN Commercial |
$210.47
|
| Rate for Payer: BCN Medicare Advantage |
$107.18
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$143.62
|
| Rate for Payer: Cofinity Commercial |
$154.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.18
|
| Rate for Payer: Mclaren Medicaid |
$70.50
|
| Rate for Payer: Meridian Medicaid |
$74.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.54
|
| Rate for Payer: PACE SWMI |
$107.18
|
| Rate for Payer: PHP Medicare Advantage |
$107.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.82
|
| Rate for Payer: Priority Health Medicare |
$107.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.18
|
| Rate for Payer: UHC Medicare Advantage |
$110.40
|
|
|
PR DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 17263
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$29,358.48 |
| Rate for Payer: Aetna Commercial |
$158.62
|
| Rate for Payer: Aetna Medicare |
$123.10
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCBS MAPPO |
$118.37
|
| Rate for Payer: BCBS Trust/PPO |
$29,358.48
|
| Rate for Payer: BCN Commercial |
$227.36
|
| Rate for Payer: BCN Medicare Advantage |
$118.37
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Cofinity Commercial |
$170.45
|
| Rate for Payer: Cofinity Commercial |
$158.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.37
|
| Rate for Payer: Mclaren Medicaid |
$77.96
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.29
|
| Rate for Payer: PACE SWMI |
$118.37
|
| Rate for Payer: PHP Medicare Advantage |
$118.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.79
|
| Rate for Payer: Priority Health Medicare |
$118.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.37
|
| Rate for Payer: UHC Medicare Advantage |
$121.92
|
|
|
PR DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 17264
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$169.22
|
| Rate for Payer: Aetna Medicare |
$131.33
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$126.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.00
|
| Rate for Payer: BCN Commercial |
$243.45
|
| Rate for Payer: BCN Medicare Advantage |
$126.28
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$181.84
|
| Rate for Payer: Cofinity Commercial |
$169.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.28
|
| Rate for Payer: Mclaren Medicaid |
$83.28
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$132.59
|
| Rate for Payer: PACE SWMI |
$126.28
|
| Rate for Payer: PHP Medicare Advantage |
$126.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.66
|
| Rate for Payer: Priority Health Medicare |
$126.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.28
|
| Rate for Payer: UHC Medicare Advantage |
$130.07
|
|
|
PR DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG
|
Professional
|
Both
|
$778.00
|
|
|
Service Code
|
HCPCS 64624
|
| Hospital Charge Code |
64624
|
| Min. Negotiated Rate |
$92.87 |
| Max. Negotiated Rate |
$1,520.45 |
| Rate for Payer: Aetna Commercial |
$190.12
|
| Rate for Payer: Aetna Medicare |
$147.56
|
| Rate for Payer: BCBS Complete |
$97.51
|
| Rate for Payer: BCBS MAPPO |
$141.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,520.45
|
| Rate for Payer: BCN Commercial |
$568.82
|
| Rate for Payer: BCN Medicare Advantage |
$141.88
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cofinity Commercial |
$190.12
|
| Rate for Payer: Cofinity Commercial |
$204.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.88
|
| Rate for Payer: Mclaren Medicaid |
$92.87
|
| Rate for Payer: Meridian Medicaid |
$97.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.97
|
| Rate for Payer: PACE SWMI |
$141.88
|
| Rate for Payer: PHP Medicare Advantage |
$141.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.04
|
| Rate for Payer: Priority Health Medicare |
$141.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.88
|
| Rate for Payer: UHC Medicare Advantage |
$146.14
|
|
|
PR DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG
|
Facility
|
IP
|
$778.00
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
64624
|
| Min. Negotiated Rate |
$474.50 |
| Max. Negotiated Rate |
$700.20 |
| Rate for Payer: Aetna Commercial |
$661.30
|
| Rate for Payer: BCBS Trust/PPO |
$601.24
|
| Rate for Payer: BCN Commercial |
$601.24
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cofinity Commercial |
$669.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.40
|
| Rate for Payer: Healthscope Commercial |
$700.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$661.30
|
| Rate for Payer: PHP Commercial |
$661.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$676.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$474.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.64
|
| Rate for Payer: UHC Core |
$649.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.50
|
|
|
PR DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG
|
Facility
|
OP
|
$778.00
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
64624
|
| Min. Negotiated Rate |
$184.78 |
| Max. Negotiated Rate |
$1,329.91 |
| Rate for Payer: Aetna Commercial |
$661.30
|
| Rate for Payer: Aetna Medicare |
$202.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.12
|
| Rate for Payer: BCBS Complete |
$1,329.91
|
| Rate for Payer: BCBS MAPPO |
$194.50
|
| Rate for Payer: BCBS Trust/PPO |
$604.90
|
| Rate for Payer: BCN Commercial |
$604.90
|
| Rate for Payer: BCN Medicare Advantage |
$194.50
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cofinity Commercial |
$669.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.50
|
| Rate for Payer: Healthscope Commercial |
$700.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.50
|
| Rate for Payer: Mclaren Medicaid |
$1,266.58
|
| Rate for Payer: Meridian Medicaid |
$1,329.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$204.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$661.30
|
| Rate for Payer: PACE Senior Care Partners |
$184.78
|
| Rate for Payer: PACE SWMI |
$194.50
|
| Rate for Payer: PHP Commercial |
$661.30
|
| Rate for Payer: PHP Medicare Advantage |
$194.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,266.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$676.86
|
| Rate for Payer: Priority Health Medicare |
$194.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$474.50
|
| Rate for Payer: Railroad Medicare Medicare |
$194.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.64
|
| Rate for Payer: UHC Core |
$649.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.50
|
| Rate for Payer: UHC Medicare Advantage |
$200.34
|
| Rate for Payer: VA VA |
$194.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.50
|
|
|
PR DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG
|
Professional
|
Both
|
$778.00
|
|
|
Service Code
|
HCPCS 64624
|
| Min. Negotiated Rate |
$92.87 |
| Max. Negotiated Rate |
$1,520.45 |
| Rate for Payer: Aetna Commercial |
$190.12
|
| Rate for Payer: Aetna Medicare |
$147.56
|
| Rate for Payer: BCBS Complete |
$97.51
|
| Rate for Payer: BCBS MAPPO |
$141.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,520.45
|
| Rate for Payer: BCN Commercial |
$568.82
|
| Rate for Payer: BCN Medicare Advantage |
$141.88
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cofinity Commercial |
$204.31
|
| Rate for Payer: Cofinity Commercial |
$190.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.88
|
| Rate for Payer: Mclaren Medicaid |
$92.87
|
| Rate for Payer: Meridian Medicaid |
$97.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.97
|
| Rate for Payer: PACE SWMI |
$141.88
|
| Rate for Payer: PHP Medicare Advantage |
$141.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.04
|
| Rate for Payer: Priority Health Medicare |
$141.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.88
|
| Rate for Payer: UHC Medicare Advantage |
$146.14
|
|
|
PR DESTRUCTION PREMALIGNANT LESION 15/>
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 17004
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$213.50 |
| Rate for Payer: Aetna Commercial |
$128.84
|
| Rate for Payer: Aetna Medicare |
$100.00
|
| Rate for Payer: BCBS Complete |
$65.98
|
| Rate for Payer: BCBS MAPPO |
$96.15
|
| Rate for Payer: BCBS Trust/PPO |
$39.53
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: BCN Medicare Advantage |
$96.15
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$138.46
|
| Rate for Payer: Cofinity Commercial |
$128.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.15
|
| Rate for Payer: Mclaren Medicaid |
$62.84
|
| Rate for Payer: Meridian Medicaid |
$65.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.96
|
| Rate for Payer: PACE SWMI |
$96.15
|
| Rate for Payer: PHP Medicare Advantage |
$96.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.26
|
| Rate for Payer: Priority Health Medicare |
$96.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.15
|
| Rate for Payer: UHC Medicare Advantage |
$99.03
|
|
