|
PR DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 90700
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$34.91 |
| Rate for Payer: Aetna Commercial |
$29.53
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS Trust/PPO |
$34.91
|
| Rate for Payer: BCN Commercial |
$34.91
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
|
|
PR DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG
|
Professional
|
Both
|
$7,478.00
|
|
|
Service Code
|
HCPCS 33645
|
| Min. Negotiated Rate |
$1,086.30 |
| Max. Negotiated Rate |
$5,234.60 |
| Rate for Payer: Aetna Commercial |
$2,284.46
|
| Rate for Payer: Aetna Medicare |
$1,773.01
|
| Rate for Payer: BCBS Complete |
$1,140.62
|
| Rate for Payer: BCBS MAPPO |
$1,704.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,139.01
|
| Rate for Payer: BCN Commercial |
$2,482.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,704.82
|
| Rate for Payer: Cash Price |
$5,982.40
|
| Rate for Payer: Cash Price |
$5,982.40
|
| Rate for Payer: Cofinity Commercial |
$2,454.94
|
| Rate for Payer: Cofinity Commercial |
$2,284.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,704.82
|
| Rate for Payer: Mclaren Medicaid |
$1,086.30
|
| Rate for Payer: Meridian Medicaid |
$1,140.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,790.06
|
| Rate for Payer: PACE SWMI |
$1,704.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,704.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,086.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,234.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,702.34
|
| Rate for Payer: Priority Health Medicare |
$1,704.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,702.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,704.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,704.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,755.96
|
|
|
PR DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS
|
Professional
|
Both
|
$3,648.00
|
|
|
Service Code
|
HCPCS 35102
|
| Min. Negotiated Rate |
$1,173.42 |
| Max. Negotiated Rate |
$2,910.88 |
| Rate for Payer: Aetna Commercial |
$2,477.57
|
| Rate for Payer: Aetna Medicare |
$1,922.89
|
| Rate for Payer: BCBS Complete |
$1,232.09
|
| Rate for Payer: BCBS MAPPO |
$1,848.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,938.33
|
| Rate for Payer: BCN Commercial |
$2,674.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,848.93
|
| Rate for Payer: Cash Price |
$2,918.40
|
| Rate for Payer: Cash Price |
$2,918.40
|
| Rate for Payer: Cofinity Commercial |
$2,662.46
|
| Rate for Payer: Cofinity Commercial |
$2,477.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,848.93
|
| Rate for Payer: Mclaren Medicaid |
$1,173.42
|
| Rate for Payer: Meridian Medicaid |
$1,232.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,941.38
|
| Rate for Payer: PACE SWMI |
$1,848.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,848.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,173.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,553.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,910.88
|
| Rate for Payer: Priority Health Medicare |
$1,848.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,910.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,848.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,848.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.40
|
|
|
PR DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS
|
Professional
|
Both
|
$3,503.00
|
|
|
Service Code
|
HCPCS 35091
|
| Min. Negotiated Rate |
$1,108.45 |
| Max. Negotiated Rate |
$2,761.38 |
| Rate for Payer: Aetna Commercial |
$2,354.15
|
| Rate for Payer: Aetna Medicare |
$1,827.10
|
| Rate for Payer: BCBS Complete |
$1,163.87
|
| Rate for Payer: BCBS MAPPO |
$1,756.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,517.81
|
| Rate for Payer: BCN Commercial |
$2,536.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,756.83
|
| Rate for Payer: Cash Price |
$2,802.40
|
| Rate for Payer: Cash Price |
$2,802.40
|
| Rate for Payer: Cofinity Commercial |
$2,529.84
|
| Rate for Payer: Cofinity Commercial |
$2,354.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,756.83
|
| Rate for Payer: Mclaren Medicaid |
$1,108.45
|
| Rate for Payer: Meridian Medicaid |
$1,163.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,844.67
|
| Rate for Payer: PACE SWMI |
$1,756.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,756.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,108.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,452.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,761.38
|
| Rate for Payer: Priority Health Medicare |
$1,756.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,761.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,756.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,756.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,809.53
|
|
|
PR DIR RPR ANEURYSM ABDOMINAL AORTA
|
Professional
|
Both
|
$5,571.00
|
|
|
Service Code
|
HCPCS 35081
|
| Min. Negotiated Rate |
$1,079.27 |
| Max. Negotiated Rate |
$3,899.70 |
| Rate for Payer: Aetna Commercial |
$2,284.77
|
| Rate for Payer: Aetna Medicare |
$1,773.25
|
| Rate for Payer: BCBS Complete |
$1,133.23
|
| Rate for Payer: BCBS MAPPO |
$1,705.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,076.67
|
| Rate for Payer: BCN Commercial |
$2,467.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,705.05
|
| Rate for Payer: Cash Price |
$4,456.80
|
| Rate for Payer: Cash Price |
$4,456.80
|
| Rate for Payer: Cofinity Commercial |
$2,455.27
|
| Rate for Payer: Cofinity Commercial |
$2,284.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,705.05
|
| Rate for Payer: Mclaren Medicaid |
$1,079.27
|
| Rate for Payer: Meridian Medicaid |
$1,133.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,790.30
|
| Rate for Payer: PACE SWMI |
$1,705.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,705.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,079.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,899.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,685.85
|
| Rate for Payer: Priority Health Medicare |
$1,705.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,685.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,705.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,705.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,756.20
|
|
|
PR DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION
|
Professional
|
Both
|
$3,647.00
|
|
|
Service Code
|
HCPCS 35011
|
| Min. Negotiated Rate |
$632.18 |
| Max. Negotiated Rate |
$2,552.90 |
| Rate for Payer: Aetna Commercial |
$1,332.34
|
| Rate for Payer: Aetna Medicare |
$1,034.05
|
| Rate for Payer: BCBS Complete |
$663.79
|
| Rate for Payer: BCBS MAPPO |
$994.28
|
| Rate for Payer: BCBS Trust/PPO |
$767.09
|
| Rate for Payer: BCN Commercial |
$1,445.02
|
| Rate for Payer: BCN Medicare Advantage |
$994.28
|
| Rate for Payer: Cash Price |
$2,917.60
|
| Rate for Payer: Cash Price |
$2,917.60
|
| Rate for Payer: Cofinity Commercial |
$1,332.34
|
| Rate for Payer: Cofinity Commercial |
$1,431.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$994.28
|
| Rate for Payer: Mclaren Medicaid |
$632.18
|
| Rate for Payer: Meridian Medicaid |
$663.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,043.99
|
| Rate for Payer: PACE SWMI |
$994.28
|
| Rate for Payer: PHP Medicare Advantage |
$994.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$632.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,552.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,572.99
|
| Rate for Payer: Priority Health Medicare |
$994.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,572.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$994.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$994.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,024.11
|
|
|
PR DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY
|
Professional
|
Both
|
$2,170.00
|
|
|
Service Code
|
HCPCS 35001
|
| Min. Negotiated Rate |
$701.41 |
| Max. Negotiated Rate |
$2,601.88 |
| Rate for Payer: Aetna Commercial |
$1,482.86
|
| Rate for Payer: Aetna Medicare |
$1,150.87
|
| Rate for Payer: BCBS Complete |
$736.48
|
| Rate for Payer: BCBS MAPPO |
$1,106.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,601.88
|
| Rate for Payer: BCN Commercial |
$1,607.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,106.61
|
| Rate for Payer: Cash Price |
$1,736.00
|
| Rate for Payer: Cash Price |
$1,736.00
|
| Rate for Payer: Cofinity Commercial |
$1,593.52
|
| Rate for Payer: Cofinity Commercial |
$1,482.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,106.61
|
| Rate for Payer: Mclaren Medicaid |
$701.41
|
| Rate for Payer: Meridian Medicaid |
$736.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,161.94
|
| Rate for Payer: PACE SWMI |
$1,106.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,106.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$701.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,519.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,750.14
|
| Rate for Payer: Priority Health Medicare |
$1,106.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,750.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,106.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,106.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,139.81
|
|
|
PR DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY
|
Professional
|
Both
|
$2,133.00
|
|
|
Service Code
|
HCPCS 35141
|
| Min. Negotiated Rate |
$381.43 |
| Max. Negotiated Rate |
$1,698.54 |
| Rate for Payer: Aetna Commercial |
$1,443.13
|
| Rate for Payer: Aetna Medicare |
$1,120.04
|
| Rate for Payer: BCBS Complete |
$715.68
|
| Rate for Payer: BCBS MAPPO |
$1,076.96
|
| Rate for Payer: BCBS Trust/PPO |
$381.43
|
| Rate for Payer: BCN Commercial |
$1,560.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,076.96
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cofinity Commercial |
$1,550.82
|
| Rate for Payer: Cofinity Commercial |
$1,443.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,076.96
|
| Rate for Payer: Mclaren Medicaid |
$681.60
|
| Rate for Payer: Meridian Medicaid |
$715.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,130.81
|
| Rate for Payer: PACE SWMI |
$1,076.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,076.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$681.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,698.54
|
| Rate for Payer: Priority Health Medicare |
$1,076.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,698.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,076.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,076.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,109.27
|
|
|
PR DIR RPR ANEURYSM & GRAFT ILIAC ARTERY
|
Professional
|
Both
|
$4,858.00
|
|
|
Service Code
|
HCPCS 35131
|
| Min. Negotiated Rate |
$862.22 |
| Max. Negotiated Rate |
$3,400.60 |
| Rate for Payer: Aetna Commercial |
$1,818.78
|
| Rate for Payer: Aetna Medicare |
$1,411.59
|
| Rate for Payer: BCBS Complete |
$905.33
|
| Rate for Payer: BCBS MAPPO |
$1,357.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,490.86
|
| Rate for Payer: BCN Commercial |
$1,965.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,357.30
|
| Rate for Payer: Cash Price |
$3,886.40
|
| Rate for Payer: Cash Price |
$3,886.40
|
| Rate for Payer: Cofinity Commercial |
$1,954.51
|
| Rate for Payer: Cofinity Commercial |
$1,818.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,357.30
|
| Rate for Payer: Mclaren Medicaid |
$862.22
|
| Rate for Payer: Meridian Medicaid |
$905.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,425.16
|
| Rate for Payer: PACE SWMI |
$1,357.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,357.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$862.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,400.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,140.06
|
| Rate for Payer: Priority Health Medicare |
$1,357.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,357.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,357.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,398.02
|
|
|
PR DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY
|
Professional
|
Both
|
$2,409.00
|
|
|
Service Code
|
HCPCS 35151
|
| Min. Negotiated Rate |
$774.89 |
| Max. Negotiated Rate |
$1,924.09 |
| Rate for Payer: Aetna Commercial |
$1,635.20
|
| Rate for Payer: Aetna Medicare |
$1,269.11
|
| Rate for Payer: BCBS Complete |
$813.63
|
| Rate for Payer: BCBS MAPPO |
$1,220.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,760.30
|
| Rate for Payer: BCN Commercial |
$1,767.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,220.30
|
| Rate for Payer: Cash Price |
$1,927.20
|
| Rate for Payer: Cash Price |
$1,927.20
|
| Rate for Payer: Cofinity Commercial |
$1,757.23
|
| Rate for Payer: Cofinity Commercial |
$1,635.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,220.30
|
| Rate for Payer: Mclaren Medicaid |
$774.89
|
| Rate for Payer: Meridian Medicaid |
$813.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,281.32
|
| Rate for Payer: PACE SWMI |
$1,220.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,220.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,686.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,924.09
|
| Rate for Payer: Priority Health Medicare |
$1,220.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,924.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,220.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,220.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,256.91
|
|
|
PR DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC
|
Professional
|
Both
|
$3,133.00
|
|
|
Service Code
|
HCPCS 35121
|
| Min. Negotiated Rate |
$283.70 |
| Max. Negotiated Rate |
$2,451.26 |
| Rate for Payer: Aetna Commercial |
$2,090.84
|
| Rate for Payer: Aetna Medicare |
$1,622.74
|
| Rate for Payer: BCBS Complete |
$1,035.05
|
| Rate for Payer: BCBS MAPPO |
$1,560.33
|
| Rate for Payer: BCBS Trust/PPO |
$283.70
|
| Rate for Payer: BCN Commercial |
$2,251.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.33
|
| Rate for Payer: Cash Price |
$2,506.40
|
| Rate for Payer: Cash Price |
$2,506.40
|
| Rate for Payer: Cofinity Commercial |
$2,246.88
|
| Rate for Payer: Cofinity Commercial |
$2,090.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,560.33
|
| Rate for Payer: Mclaren Medicaid |
$985.76
|
| Rate for Payer: Meridian Medicaid |
$1,035.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,638.35
|
| Rate for Payer: PACE SWMI |
$1,560.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$985.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,193.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,451.26
|
| Rate for Payer: Priority Health Medicare |
$1,560.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,451.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,560.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,607.14
|
|
|
PR DIR RPR ANEURYSM SPLENIC ARTERY
|
Professional
|
Both
|
$2,720.00
|
|
|
Service Code
|
HCPCS 35111
|
| Min. Negotiated Rate |
$829.42 |
| Max. Negotiated Rate |
$2,062.94 |
| Rate for Payer: Aetna Commercial |
$1,758.39
|
| Rate for Payer: Aetna Medicare |
$1,364.72
|
| Rate for Payer: BCBS Complete |
$870.89
|
| Rate for Payer: BCBS MAPPO |
$1,312.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.86
|
| Rate for Payer: BCN Commercial |
$1,895.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,312.23
|
| Rate for Payer: Cash Price |
$2,176.00
|
| Rate for Payer: Cash Price |
$2,176.00
|
| Rate for Payer: Cofinity Commercial |
$1,889.61
|
| Rate for Payer: Cofinity Commercial |
$1,758.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,312.23
|
| Rate for Payer: Mclaren Medicaid |
$829.42
|
| Rate for Payer: Meridian Medicaid |
$870.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,377.84
|
| Rate for Payer: PACE SWMI |
$1,312.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,312.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$829.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,904.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,062.94
|
| Rate for Payer: Priority Health Medicare |
$1,312.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,062.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,312.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,312.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,351.60
|
|
|
PR DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS
|
Professional
|
Both
|
$5,390.00
|
|
|
Service Code
|
HCPCS 35092
|
| Min. Negotiated Rate |
$1,617.31 |
| Max. Negotiated Rate |
$4,007.77 |
| Rate for Payer: Aetna Commercial |
$3,414.70
|
| Rate for Payer: Aetna Medicare |
$2,650.21
|
| Rate for Payer: BCBS Complete |
$1,698.18
|
| Rate for Payer: BCBS MAPPO |
$2,548.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,136.58
|
| Rate for Payer: BCN Commercial |
$3,681.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,548.28
|
| Rate for Payer: Cash Price |
$4,312.00
|
| Rate for Payer: Cash Price |
$4,312.00
|
| Rate for Payer: Cofinity Commercial |
$3,669.52
|
| Rate for Payer: Cofinity Commercial |
$3,414.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,548.28
|
| Rate for Payer: Mclaren Medicaid |
$1,617.31
|
| Rate for Payer: Meridian Medicaid |
$1,698.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,675.69
|
| Rate for Payer: PACE SWMI |
$2,548.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,548.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,617.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,773.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,007.77
|
| Rate for Payer: Priority Health Medicare |
$2,548.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,007.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,548.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,548.28
|
| Rate for Payer: UHC Medicare Advantage |
$2,624.73
|
|
|
PR DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN
|
Professional
|
Both
|
$3,783.00
|
|
|
Service Code
|
HCPCS 35122
|
| Min. Negotiated Rate |
$1,178.96 |
| Max. Negotiated Rate |
$2,930.03 |
| Rate for Payer: Aetna Commercial |
$2,500.36
|
| Rate for Payer: Aetna Medicare |
$1,940.58
|
| Rate for Payer: BCBS Complete |
$1,237.91
|
| Rate for Payer: BCBS MAPPO |
$1,865.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.66
|
| Rate for Payer: BCN Commercial |
$2,691.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,865.94
|
| Rate for Payer: Cash Price |
$3,026.40
|
| Rate for Payer: Cash Price |
$3,026.40
|
| Rate for Payer: Cofinity Commercial |
$2,500.36
|
| Rate for Payer: Cofinity Commercial |
$2,686.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,865.94
|
| Rate for Payer: Mclaren Medicaid |
$1,178.96
|
| Rate for Payer: Meridian Medicaid |
$1,237.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,959.24
|
| Rate for Payer: PACE SWMI |
$1,865.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,865.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,178.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,648.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,930.03
|
| Rate for Payer: Priority Health Medicare |
$1,865.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,930.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,865.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,865.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,921.92
|
|
|
PR DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS
|
Professional
|
Both
|
$3,490.00
|
|
|
Service Code
|
HCPCS 35103
|
| Min. Negotiated Rate |
$621.81 |
| Max. Negotiated Rate |
$3,446.55 |
| Rate for Payer: Aetna Commercial |
$2,935.52
|
| Rate for Payer: Aetna Medicare |
$2,278.32
|
| Rate for Payer: BCBS Complete |
$1,450.38
|
| Rate for Payer: BCBS MAPPO |
$2,190.69
|
| Rate for Payer: BCBS Trust/PPO |
$621.81
|
| Rate for Payer: BCN Commercial |
$3,166.15
|
| Rate for Payer: BCN Medicare Advantage |
$2,190.69
|
| Rate for Payer: Cash Price |
$2,792.00
|
| Rate for Payer: Cash Price |
$2,792.00
|
| Rate for Payer: Cofinity Commercial |
$3,154.59
|
| Rate for Payer: Cofinity Commercial |
$2,935.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,190.69
|
| Rate for Payer: Mclaren Medicaid |
$1,381.31
|
| Rate for Payer: Meridian Medicaid |
$1,450.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,300.22
|
| Rate for Payer: PACE SWMI |
$2,190.69
|
| Rate for Payer: PHP Medicare Advantage |
$2,190.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,443.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,446.55
|
| Rate for Payer: Priority Health Medicare |
$2,190.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,446.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,190.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,190.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,256.41
|
|
|
PR DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA
|
Professional
|
Both
|
$4,202.00
|
|
|
Service Code
|
HCPCS 35082
|
| Min. Negotiated Rate |
$750.19 |
| Max. Negotiated Rate |
$3,356.12 |
| Rate for Payer: Aetna Commercial |
$2,856.10
|
| Rate for Payer: Aetna Medicare |
$2,216.68
|
| Rate for Payer: BCBS Complete |
$1,414.59
|
| Rate for Payer: BCBS MAPPO |
$2,131.42
|
| Rate for Payer: BCBS Trust/PPO |
$750.19
|
| Rate for Payer: BCN Commercial |
$3,083.06
|
| Rate for Payer: BCN Medicare Advantage |
$2,131.42
|
| Rate for Payer: Cash Price |
$3,361.60
|
| Rate for Payer: Cash Price |
$3,361.60
|
| Rate for Payer: Cofinity Commercial |
$2,856.10
|
| Rate for Payer: Cofinity Commercial |
$3,069.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,131.42
|
| Rate for Payer: Mclaren Medicaid |
$1,347.23
|
| Rate for Payer: Meridian Medicaid |
$1,414.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,237.99
|
| Rate for Payer: PACE SWMI |
$2,131.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,131.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,347.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,941.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,356.12
|
| Rate for Payer: Priority Health Medicare |
$2,131.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,356.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,131.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,131.42
|
| Rate for Payer: UHC Medicare Advantage |
$2,195.36
|
|
|
PR DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS
|
Professional
|
Both
|
$3,850.00
|
|
|
Service Code
|
HCPCS 35013
|
| Min. Negotiated Rate |
$793.43 |
| Max. Negotiated Rate |
$2,695.00 |
| Rate for Payer: Aetna Commercial |
$1,673.28
|
| Rate for Payer: Aetna Medicare |
$1,298.67
|
| Rate for Payer: BCBS Complete |
$833.10
|
| Rate for Payer: BCBS MAPPO |
$1,248.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,152.22
|
| Rate for Payer: BCN Commercial |
$1,815.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,248.72
|
| Rate for Payer: Cash Price |
$3,080.00
|
| Rate for Payer: Cash Price |
$3,080.00
|
| Rate for Payer: Cofinity Commercial |
$1,798.16
|
| Rate for Payer: Cofinity Commercial |
$1,673.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,248.72
|
| Rate for Payer: Mclaren Medicaid |
$793.43
|
| Rate for Payer: Meridian Medicaid |
$833.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,311.16
|
| Rate for Payer: PACE SWMI |
$1,248.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,248.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$793.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,695.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,976.76
|
| Rate for Payer: Priority Health Medicare |
$1,248.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,976.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,248.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,248.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,286.18
|
|
|
PR DIR RPR RUPTD ANEURYSM CAROTID-SUBCLAVIAN ARTERY
|
Professional
|
Both
|
$2,492.00
|
|
|
Service Code
|
HCPCS 35002
|
| Min. Negotiated Rate |
$711.21 |
| Max. Negotiated Rate |
$2,959.01 |
| Rate for Payer: Aetna Commercial |
$1,504.38
|
| Rate for Payer: Aetna Medicare |
$1,167.58
|
| Rate for Payer: BCBS Complete |
$746.77
|
| Rate for Payer: BCBS MAPPO |
$1,122.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,959.01
|
| Rate for Payer: BCN Commercial |
$1,623.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,122.67
|
| Rate for Payer: Cash Price |
$1,993.60
|
| Rate for Payer: Cash Price |
$1,993.60
|
| Rate for Payer: Cofinity Commercial |
$1,616.64
|
| Rate for Payer: Cofinity Commercial |
$1,504.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,122.67
|
| Rate for Payer: Mclaren Medicaid |
$711.21
|
| Rate for Payer: Meridian Medicaid |
$746.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,178.80
|
| Rate for Payer: PACE SWMI |
$1,122.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,122.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$711.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,767.16
|
| Rate for Payer: Priority Health Medicare |
$1,122.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,767.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,122.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,156.35
|
|
|
PR DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY
|
Professional
|
Both
|
$3,384.00
|
|
|
Service Code
|
HCPCS 35132
|
| Min. Negotiated Rate |
$1,019.21 |
| Max. Negotiated Rate |
$2,534.79 |
| Rate for Payer: Aetna Commercial |
$2,161.98
|
| Rate for Payer: Aetna Medicare |
$1,677.96
|
| Rate for Payer: BCBS Complete |
$1,070.17
|
| Rate for Payer: BCBS MAPPO |
$1,613.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,010.18
|
| Rate for Payer: BCN Commercial |
$2,328.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,613.42
|
| Rate for Payer: Cash Price |
$2,707.20
|
| Rate for Payer: Cash Price |
$2,707.20
|
| Rate for Payer: Cofinity Commercial |
$2,323.32
|
| Rate for Payer: Cofinity Commercial |
$2,161.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,613.42
|
| Rate for Payer: Mclaren Medicaid |
$1,019.21
|
| Rate for Payer: Meridian Medicaid |
$1,070.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,694.09
|
| Rate for Payer: PACE SWMI |
$1,613.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,613.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,019.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,534.79
|
| Rate for Payer: Priority Health Medicare |
$1,613.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,534.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,613.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,613.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,661.82
|
|
|
PR DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART
|
Professional
|
Both
|
$2,559.00
|
|
|
Service Code
|
HCPCS 35142
|
| Min. Negotiated Rate |
$571.62 |
| Max. Negotiated Rate |
$2,051.23 |
| Rate for Payer: Aetna Commercial |
$1,742.13
|
| Rate for Payer: Aetna Medicare |
$1,352.10
|
| Rate for Payer: BCBS Complete |
$864.41
|
| Rate for Payer: BCBS MAPPO |
$1,300.10
|
| Rate for Payer: BCBS Trust/PPO |
$571.62
|
| Rate for Payer: BCN Commercial |
$1,884.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,300.10
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cofinity Commercial |
$1,742.13
|
| Rate for Payer: Cofinity Commercial |
$1,872.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,300.10
|
| Rate for Payer: Mclaren Medicaid |
$823.25
|
| Rate for Payer: Meridian Medicaid |
$864.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,365.10
|
| Rate for Payer: PACE SWMI |
$1,300.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,300.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$823.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,051.23
|
| Rate for Payer: Priority Health Medicare |
$1,300.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,051.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,300.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,300.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,339.10
|
|
|
PR DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY
|
Professional
|
Both
|
$2,683.00
|
|
|
Service Code
|
HCPCS 35152
|
| Min. Negotiated Rate |
$872.02 |
| Max. Negotiated Rate |
$2,435.46 |
| Rate for Payer: Aetna Commercial |
$1,848.61
|
| Rate for Payer: Aetna Medicare |
$1,434.74
|
| Rate for Payer: BCBS Complete |
$915.62
|
| Rate for Payer: BCBS MAPPO |
$1,379.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,435.46
|
| Rate for Payer: BCN Commercial |
$1,992.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,379.56
|
| Rate for Payer: Cash Price |
$2,146.40
|
| Rate for Payer: Cash Price |
$2,146.40
|
| Rate for Payer: Cofinity Commercial |
$1,848.61
|
| Rate for Payer: Cofinity Commercial |
$1,986.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,379.56
|
| Rate for Payer: Mclaren Medicaid |
$872.02
|
| Rate for Payer: Meridian Medicaid |
$915.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,448.54
|
| Rate for Payer: PACE SWMI |
$1,379.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,379.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$872.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,878.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,168.79
|
| Rate for Payer: Priority Health Medicare |
$1,379.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,168.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,379.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,420.95
|
|
|
PR DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY
|
Professional
|
Both
|
$3,357.00
|
|
|
Service Code
|
HCPCS 35045
|
| Min. Negotiated Rate |
$606.84 |
| Max. Negotiated Rate |
$2,349.90 |
| Rate for Payer: Aetna Commercial |
$1,280.85
|
| Rate for Payer: Aetna Medicare |
$994.09
|
| Rate for Payer: BCBS Complete |
$637.18
|
| Rate for Payer: BCBS MAPPO |
$955.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.22
|
| Rate for Payer: BCN Commercial |
$1,389.31
|
| Rate for Payer: BCN Medicare Advantage |
$955.86
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cofinity Commercial |
$1,280.85
|
| Rate for Payer: Cofinity Commercial |
$1,376.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$955.86
|
| Rate for Payer: Mclaren Medicaid |
$606.84
|
| Rate for Payer: Meridian Medicaid |
$637.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,003.65
|
| Rate for Payer: PACE SWMI |
$955.86
|
| Rate for Payer: PHP Medicare Advantage |
$955.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$606.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,349.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,512.35
|
| Rate for Payer: Priority Health Medicare |
$955.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,512.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$955.86
|
| Rate for Payer: UHC Medicare Advantage |
$984.54
|
|
|
PR DISARTICULATION HIP
|
Professional
|
Both
|
$5,325.00
|
|
|
Service Code
|
HCPCS 27295
|
| Min. Negotiated Rate |
$808.12 |
| Max. Negotiated Rate |
$3,727.50 |
| Rate for Payer: Aetna Commercial |
$1,665.18
|
| Rate for Payer: Aetna Medicare |
$1,292.38
|
| Rate for Payer: BCBS Complete |
$848.53
|
| Rate for Payer: BCBS MAPPO |
$1,242.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,334.10
|
| Rate for Payer: BCN Commercial |
$1,837.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,242.67
|
| Rate for Payer: Cash Price |
$4,260.00
|
| Rate for Payer: Cash Price |
$4,260.00
|
| Rate for Payer: Cofinity Commercial |
$1,789.44
|
| Rate for Payer: Cofinity Commercial |
$1,665.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,242.67
|
| Rate for Payer: Mclaren Medicaid |
$808.12
|
| Rate for Payer: Meridian Medicaid |
$848.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,304.80
|
| Rate for Payer: PACE SWMI |
$1,242.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,242.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,727.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.56
|
| Rate for Payer: Priority Health Medicare |
$1,242.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,920.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,242.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,242.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,279.95
|
|
|
PR DISARTICULATION KNEE
|
Professional
|
Both
|
$2,875.00
|
|
|
Service Code
|
HCPCS 27598
|
| Min. Negotiated Rate |
$442.83 |
| Max. Negotiated Rate |
$2,012.50 |
| Rate for Payer: Aetna Commercial |
$922.90
|
| Rate for Payer: Aetna Medicare |
$716.28
|
| Rate for Payer: BCBS Complete |
$464.97
|
| Rate for Payer: BCBS MAPPO |
$688.73
|
| Rate for Payer: BCBS Trust/PPO |
$797.73
|
| Rate for Payer: BCN Commercial |
$1,014.00
|
| Rate for Payer: BCN Medicare Advantage |
$688.73
|
| Rate for Payer: Cash Price |
$2,300.00
|
| Rate for Payer: Cash Price |
$2,300.00
|
| Rate for Payer: Cofinity Commercial |
$922.90
|
| Rate for Payer: Cofinity Commercial |
$991.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.73
|
| Rate for Payer: Mclaren Medicaid |
$442.83
|
| Rate for Payer: Meridian Medicaid |
$464.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$723.17
|
| Rate for Payer: PACE SWMI |
$688.73
|
| Rate for Payer: PHP Medicare Advantage |
$688.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,059.60
|
| Rate for Payer: Priority Health Medicare |
$688.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,059.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$688.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$688.73
|
| Rate for Payer: UHC Medicare Advantage |
$709.39
|
|
|
PR DISARTICULATION SHOULDER
|
Professional
|
Both
|
$1,957.00
|
|
|
Service Code
|
HCPCS 23920
|
| Min. Negotiated Rate |
$491.15 |
| Max. Negotiated Rate |
$1,718.84 |
| Rate for Payer: Aetna Commercial |
$1,482.52
|
| Rate for Payer: Aetna Medicare |
$1,150.61
|
| Rate for Payer: BCBS Complete |
$759.07
|
| Rate for Payer: BCBS MAPPO |
$1,106.36
|
| Rate for Payer: BCBS Trust/PPO |
$491.15
|
| Rate for Payer: BCN Commercial |
$1,644.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,106.36
|
| Rate for Payer: Cash Price |
$1,565.60
|
| Rate for Payer: Cash Price |
$1,565.60
|
| Rate for Payer: Cofinity Commercial |
$1,593.16
|
| Rate for Payer: Cofinity Commercial |
$1,482.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,106.36
|
| Rate for Payer: Mclaren Medicaid |
$722.92
|
| Rate for Payer: Meridian Medicaid |
$759.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,161.68
|
| Rate for Payer: PACE SWMI |
$1,106.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,106.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$722.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,718.84
|
| Rate for Payer: Priority Health Medicare |
$1,106.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,718.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,106.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,106.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,139.55
|
|
