PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Professional
|
Both
|
$311.00
|
|
Service Code
|
HCPCS 69000
|
Min. Negotiated Rate |
$80.94 |
Max. Negotiated Rate |
$5,524.43 |
Rate for Payer: Aetna Commercial |
$162.84
|
Rate for Payer: Aetna Medicare |
$126.38
|
Rate for Payer: BCBS Complete |
$84.99
|
Rate for Payer: BCBS MAPPO |
$121.52
|
Rate for Payer: BCBS Trust/PPO |
$5,524.43
|
Rate for Payer: BCN Commercial |
$275.12
|
Rate for Payer: BCN Medicare Advantage |
$121.52
|
Rate for Payer: Cash Price |
$248.80
|
Rate for Payer: Cash Price |
$248.80
|
Rate for Payer: Cofinity Commercial |
$162.84
|
Rate for Payer: Cofinity Commercial |
$174.99
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.52
|
Rate for Payer: Mclaren Medicaid |
$80.94
|
Rate for Payer: Meridian Medicaid |
$84.99
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$127.60
|
Rate for Payer: PACE SWMI |
$121.52
|
Rate for Payer: PHP Medicare Advantage |
$121.52
|
Rate for Payer: Priority Health Choice Medicaid |
$80.94
|
Rate for Payer: Priority Health Cigna Priority Health |
$217.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.80
|
Rate for Payer: Priority Health Medicare |
$121.52
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$176.80
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$121.52
|
Rate for Payer: UHC Dual Complete DSNP |
$121.52
|
Rate for Payer: UHC Medicare Advantage |
$125.17
|
|
PR DRAINAGE FINGER ABSCESS COMPLICATED
|
Professional
|
Both
|
$795.00
|
|
Service Code
|
HCPCS 26011
|
Min. Negotiated Rate |
$119.92 |
Max. Negotiated Rate |
$712.98 |
Rate for Payer: Aetna Commercial |
$243.79
|
Rate for Payer: Aetna Medicare |
$189.21
|
Rate for Payer: BCBS Complete |
$125.92
|
Rate for Payer: BCBS MAPPO |
$181.93
|
Rate for Payer: BCBS Trust/PPO |
$452.09
|
Rate for Payer: BCN Commercial |
$712.98
|
Rate for Payer: BCN Medicare Advantage |
$181.93
|
Rate for Payer: Cash Price |
$636.00
|
Rate for Payer: Cash Price |
$636.00
|
Rate for Payer: Cofinity Commercial |
$243.79
|
Rate for Payer: Cofinity Commercial |
$261.98
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.93
|
Rate for Payer: Mclaren Medicaid |
$119.92
|
Rate for Payer: Meridian Medicaid |
$125.92
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$191.03
|
Rate for Payer: PACE SWMI |
$181.93
|
Rate for Payer: PHP Medicare Advantage |
$181.93
|
Rate for Payer: Priority Health Choice Medicaid |
$119.92
|
Rate for Payer: Priority Health Cigna Priority Health |
$556.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$285.97
|
Rate for Payer: Priority Health Medicare |
$181.93
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$285.97
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$181.93
|
Rate for Payer: UHC Dual Complete DSNP |
$181.93
|
Rate for Payer: UHC Medicare Advantage |
$187.39
|
|
PR DRAINAGE FINGER ABSCESS SIMPLE
|
Professional
|
Both
|
$565.00
|
|
Service Code
|
HCPCS 26010
|
Min. Negotiated Rate |
$91.59 |
Max. Negotiated Rate |
$509.69 |
Rate for Payer: Aetna Commercial |
$184.26
|
Rate for Payer: Aetna Medicare |
$143.01
|
Rate for Payer: BCBS Complete |
$96.17
|
Rate for Payer: BCBS MAPPO |
$137.51
|
Rate for Payer: BCBS Trust/PPO |
$348.51
|
Rate for Payer: BCN Commercial |
$509.69
|
Rate for Payer: BCN Medicare Advantage |
$137.51
|
Rate for Payer: Cash Price |
$452.00
|
Rate for Payer: Cash Price |
$452.00
|
Rate for Payer: Cofinity Commercial |
$184.26
|
Rate for Payer: Cofinity Commercial |
$198.01
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.51
|
Rate for Payer: Mclaren Medicaid |
$91.59
|
Rate for Payer: Meridian Medicaid |
$96.17
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.39
|
Rate for Payer: PACE SWMI |
$137.51
|
Rate for Payer: PHP Medicare Advantage |
$137.51
|
Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
Rate for Payer: Priority Health Cigna Priority Health |
$395.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.03
|
Rate for Payer: Priority Health Medicare |
$137.51
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$217.03
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$137.51
|
Rate for Payer: UHC Dual Complete DSNP |
$137.51
|
Rate for Payer: UHC Medicare Advantage |
$141.64
|
|
PR DRAINAGE OF PALMAR BURSA MULTIPLE BURSA
|
Professional
|
Both
|
$3,116.00
|
|
Service Code
|
HCPCS 26030
|
Min. Negotiated Rate |
$104.00 |
Max. Negotiated Rate |
$2,181.20 |
Rate for Payer: Aetna Commercial |
$649.58
|
Rate for Payer: Aetna Medicare |
$504.15
|
Rate for Payer: BCBS Complete |
$336.37
|
Rate for Payer: BCBS MAPPO |
$484.76
|
Rate for Payer: BCBS Trust/PPO |
$104.00
|
Rate for Payer: BCN Commercial |
$727.15
|
Rate for Payer: BCN Medicare Advantage |
$484.76
|
Rate for Payer: Cash Price |
$2,492.80
|
Rate for Payer: Cash Price |
$2,492.80
|
Rate for Payer: Cofinity Commercial |
$698.05
|
Rate for Payer: Cofinity Commercial |
$649.58
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.76
|
Rate for Payer: Mclaren Medicaid |
$320.35
|
Rate for Payer: Meridian Medicaid |
$336.37
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$509.00
|
Rate for Payer: PACE SWMI |
$484.76
|
Rate for Payer: PHP Medicare Advantage |
$484.76
|
Rate for Payer: Priority Health Choice Medicaid |
$320.35
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,181.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$759.84
|
Rate for Payer: Priority Health Medicare |
$484.76
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$759.84
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$484.76
|
Rate for Payer: UHC Dual Complete DSNP |
$484.76
|
Rate for Payer: UHC Medicare Advantage |
$499.30
|
|
PR DRAINAGE OF PALMAR BURSA SINGLE BURSA
|
Professional
|
Both
|
$1,336.00
|
|
Service Code
|
HCPCS 26025
|
Min. Negotiated Rate |
$84.90 |
Max. Negotiated Rate |
$935.20 |
Rate for Payer: Aetna Commercial |
$553.92
|
Rate for Payer: Aetna Medicare |
$429.90
|
Rate for Payer: BCBS Complete |
$287.16
|
Rate for Payer: BCBS MAPPO |
$413.37
|
Rate for Payer: BCBS Trust/PPO |
$84.90
|
Rate for Payer: BCN Commercial |
$621.60
|
Rate for Payer: BCN Medicare Advantage |
$413.37
|
Rate for Payer: Cash Price |
$1,068.80
|
Rate for Payer: Cash Price |
$1,068.80
|
Rate for Payer: Cofinity Commercial |
$595.25
|
Rate for Payer: Cofinity Commercial |
$553.92
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.37
|
Rate for Payer: Mclaren Medicaid |
$273.49
|
Rate for Payer: Meridian Medicaid |
$287.16
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$434.04
|
Rate for Payer: PACE SWMI |
$413.37
|
Rate for Payer: PHP Medicare Advantage |
$413.37
|
Rate for Payer: Priority Health Choice Medicaid |
$273.49
|
Rate for Payer: Priority Health Cigna Priority Health |
$935.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$649.55
|
Rate for Payer: Priority Health Medicare |
$413.37
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$649.55
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$413.37
|
Rate for Payer: UHC Dual Complete DSNP |
$413.37
|
Rate for Payer: UHC Medicare Advantage |
$425.77
|
|
PR DRAINAGE OF RETROPERITONEAL ABSCESS OPEN
|
Professional
|
Both
|
$2,205.00
|
|
Service Code
|
HCPCS 49060
|
Min. Negotiated Rate |
$698.85 |
Max. Negotiated Rate |
$1,919.15 |
Rate for Payer: Aetna Commercial |
$1,455.62
|
Rate for Payer: Aetna Medicare |
$1,129.73
|
Rate for Payer: BCBS Complete |
$733.79
|
Rate for Payer: BCBS MAPPO |
$1,086.28
|
Rate for Payer: BCBS Trust/PPO |
$798.26
|
Rate for Payer: BCN Commercial |
$1,595.04
|
Rate for Payer: BCN Medicare Advantage |
$1,086.28
|
Rate for Payer: Cash Price |
$1,764.00
|
Rate for Payer: Cash Price |
$1,764.00
|
Rate for Payer: Cofinity Commercial |
$1,564.24
|
Rate for Payer: Cofinity Commercial |
$1,455.62
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,086.28
|
Rate for Payer: Mclaren Medicaid |
$698.85
|
Rate for Payer: Meridian Medicaid |
$733.79
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,140.59
|
Rate for Payer: PACE SWMI |
$1,086.28
|
Rate for Payer: PHP Medicare Advantage |
$1,086.28
|
Rate for Payer: Priority Health Choice Medicaid |
$698.85
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,543.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,919.15
|
Rate for Payer: Priority Health Medicare |
$1,086.28
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,919.15
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.28
|
Rate for Payer: UHC Dual Complete DSNP |
$1,086.28
|
Rate for Payer: UHC Medicare Advantage |
$1,118.87
|
|
PR DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Professional
|
Both
|
$1,691.00
|
|
Service Code
|
HCPCS 58822
|
Min. Negotiated Rate |
$280.53 |
Max. Negotiated Rate |
$1,183.70 |
Rate for Payer: Aetna Commercial |
$951.25
|
Rate for Payer: Aetna Medicare |
$738.29
|
Rate for Payer: BCBS Complete |
$482.63
|
Rate for Payer: BCBS MAPPO |
$709.89
|
Rate for Payer: BCBS Trust/PPO |
$280.53
|
Rate for Payer: BCN Commercial |
$1,050.17
|
Rate for Payer: BCN Medicare Advantage |
$709.89
|
Rate for Payer: Cash Price |
$1,352.80
|
Rate for Payer: Cash Price |
$1,352.80
|
Rate for Payer: Cofinity Commercial |
$951.25
|
Rate for Payer: Cofinity Commercial |
$1,022.24
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.89
|
Rate for Payer: Mclaren Medicaid |
$459.65
|
Rate for Payer: Meridian Medicaid |
$482.63
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$745.38
|
Rate for Payer: PACE SWMI |
$709.89
|
Rate for Payer: PHP Medicare Advantage |
$709.89
|
Rate for Payer: Priority Health Choice Medicaid |
$459.65
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,183.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,017.39
|
Rate for Payer: Priority Health Medicare |
$709.89
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,017.39
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$709.89
|
Rate for Payer: UHC Dual Complete DSNP |
$709.89
|
Rate for Payer: UHC Medicare Advantage |
$731.19
|
|
PR DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN
|
Professional
|
Both
|
$879.00
|
|
Service Code
|
HCPCS 58820
|
Min. Negotiated Rate |
$136.83 |
Max. Negotiated Rate |
$615.30 |
Rate for Payer: Aetna Commercial |
$448.44
|
Rate for Payer: Aetna Medicare |
$348.05
|
Rate for Payer: BCBS Complete |
$230.14
|
Rate for Payer: BCBS MAPPO |
$334.66
|
Rate for Payer: BCBS Trust/PPO |
$136.83
|
Rate for Payer: BCN Commercial |
$500.41
|
Rate for Payer: BCN Medicare Advantage |
$334.66
|
Rate for Payer: Cash Price |
$703.20
|
Rate for Payer: Cash Price |
$703.20
|
Rate for Payer: Cofinity Commercial |
$481.91
|
Rate for Payer: Cofinity Commercial |
$448.44
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.66
|
Rate for Payer: Mclaren Medicaid |
$219.18
|
Rate for Payer: Meridian Medicaid |
$230.14
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$351.39
|
Rate for Payer: PACE SWMI |
$334.66
|
Rate for Payer: PHP Medicare Advantage |
$334.66
|
Rate for Payer: Priority Health Choice Medicaid |
$219.18
|
Rate for Payer: Priority Health Cigna Priority Health |
$615.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$484.78
|
Rate for Payer: Priority Health Medicare |
$334.66
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$484.78
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$334.66
|
Rate for Payer: UHC Dual Complete DSNP |
$334.66
|
Rate for Payer: UHC Medicare Advantage |
$344.70
|
|
PR DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL
|
Professional
|
Both
|
$1,580.00
|
|
Service Code
|
HCPCS 58805
|
Min. Negotiated Rate |
$275.77 |
Max. Negotiated Rate |
$1,106.00 |
Rate for Payer: Aetna Commercial |
$567.95
|
Rate for Payer: Aetna Medicare |
$440.79
|
Rate for Payer: BCBS Complete |
$290.29
|
Rate for Payer: BCBS MAPPO |
$423.84
|
Rate for Payer: BCBS Trust/PPO |
$275.77
|
Rate for Payer: BCN Commercial |
$630.89
|
Rate for Payer: BCN Medicare Advantage |
$423.84
|
Rate for Payer: Cash Price |
$1,264.00
|
Rate for Payer: Cash Price |
$1,264.00
|
Rate for Payer: Cofinity Commercial |
$610.33
|
Rate for Payer: Cofinity Commercial |
$567.95
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$423.84
|
Rate for Payer: Mclaren Medicaid |
$276.47
|
Rate for Payer: Meridian Medicaid |
$290.29
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$445.03
|
Rate for Payer: PACE SWMI |
$423.84
|
Rate for Payer: PHP Medicare Advantage |
$423.84
|
Rate for Payer: Priority Health Choice Medicaid |
$276.47
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,106.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.19
|
Rate for Payer: Priority Health Medicare |
$423.84
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$611.19
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$423.84
|
Rate for Payer: UHC Dual Complete DSNP |
$423.84
|
Rate for Payer: UHC Medicare Advantage |
$436.56
|
|
PR DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR
|
Professional
|
Both
|
$974.00
|
|
Service Code
|
HCPCS 58800
|
Min. Negotiated Rate |
$203.84 |
Max. Negotiated Rate |
$681.80 |
Rate for Payer: Aetna Commercial |
$417.69
|
Rate for Payer: Aetna Medicare |
$324.18
|
Rate for Payer: BCBS Complete |
$214.03
|
Rate for Payer: BCBS MAPPO |
$311.71
|
Rate for Payer: BCBS Trust/PPO |
$503.47
|
Rate for Payer: BCN Commercial |
$535.10
|
Rate for Payer: BCN Medicare Advantage |
$311.71
|
Rate for Payer: Cash Price |
$779.20
|
Rate for Payer: Cash Price |
$779.20
|
Rate for Payer: Cofinity Commercial |
$448.86
|
Rate for Payer: Cofinity Commercial |
$417.69
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.71
|
Rate for Payer: Mclaren Medicaid |
$203.84
|
Rate for Payer: Meridian Medicaid |
$214.03
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$327.30
|
Rate for Payer: PACE SWMI |
$311.71
|
Rate for Payer: PHP Medicare Advantage |
$311.71
|
Rate for Payer: Priority Health Choice Medicaid |
$203.84
|
Rate for Payer: Priority Health Cigna Priority Health |
$681.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$450.23
|
Rate for Payer: Priority Health Medicare |
$311.71
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$450.23
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$311.71
|
Rate for Payer: UHC Dual Complete DSNP |
$311.71
|
Rate for Payer: UHC Medicare Advantage |
$321.06
|
|
PR DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN
|
Professional
|
Both
|
$2,773.00
|
|
Service Code
|
HCPCS 49020
|
Min. Negotiated Rate |
$537.81 |
Max. Negotiated Rate |
$2,791.69 |
Rate for Payer: Aetna Commercial |
$2,117.62
|
Rate for Payer: Aetna Medicare |
$1,643.52
|
Rate for Payer: BCBS Complete |
$1,068.83
|
Rate for Payer: BCBS MAPPO |
$1,580.31
|
Rate for Payer: BCBS Trust/PPO |
$537.81
|
Rate for Payer: BCN Commercial |
$2,320.24
|
Rate for Payer: BCN Medicare Advantage |
$1,580.31
|
Rate for Payer: Cash Price |
$2,218.40
|
Rate for Payer: Cash Price |
$2,218.40
|
Rate for Payer: Cofinity Commercial |
$2,275.65
|
Rate for Payer: Cofinity Commercial |
$2,117.62
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.31
|
Rate for Payer: Mclaren Medicaid |
$1,017.93
|
Rate for Payer: Meridian Medicaid |
$1,068.83
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,659.33
|
Rate for Payer: PACE SWMI |
$1,580.31
|
Rate for Payer: PHP Medicare Advantage |
$1,580.31
|
Rate for Payer: Priority Health Choice Medicaid |
$1,017.93
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,941.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,791.69
|
Rate for Payer: Priority Health Medicare |
$1,580.31
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,791.69
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,580.31
|
Rate for Payer: UHC Dual Complete DSNP |
$1,580.31
|
Rate for Payer: UHC Medicare Advantage |
$1,627.72
|
|
PR DRAINAGE SCROTAL WALL ABSCESS
|
Professional
|
Both
|
$391.00
|
|
Service Code
|
HCPCS 55100
|
Min. Negotiated Rate |
$107.99 |
Max. Negotiated Rate |
$1,199.77 |
Rate for Payer: Aetna Commercial |
$218.53
|
Rate for Payer: Aetna Medicare |
$169.60
|
Rate for Payer: BCBS Complete |
$113.39
|
Rate for Payer: BCBS MAPPO |
$163.08
|
Rate for Payer: BCBS Trust/PPO |
$1,199.77
|
Rate for Payer: BCN Commercial |
$336.70
|
Rate for Payer: BCN Medicare Advantage |
$163.08
|
Rate for Payer: Cash Price |
$312.80
|
Rate for Payer: Cash Price |
$312.80
|
Rate for Payer: Cofinity Commercial |
$234.84
|
Rate for Payer: Cofinity Commercial |
$218.53
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.08
|
Rate for Payer: Mclaren Medicaid |
$107.99
|
Rate for Payer: Meridian Medicaid |
$113.39
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.23
|
Rate for Payer: PACE SWMI |
$163.08
|
Rate for Payer: PHP Medicare Advantage |
$163.08
|
Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
Rate for Payer: Priority Health Cigna Priority Health |
$273.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.10
|
Rate for Payer: Priority Health Medicare |
$163.08
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$269.10
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$163.08
|
Rate for Payer: UHC Dual Complete DSNP |
$163.08
|
Rate for Payer: UHC Medicare Advantage |
$167.97
|
|
PR DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN
|
Professional
|
Both
|
$2,180.00
|
|
Service Code
|
HCPCS 49040
|
Min. Negotiated Rate |
$640.83 |
Max. Negotiated Rate |
$1,763.34 |
Rate for Payer: Aetna Commercial |
$1,335.77
|
Rate for Payer: Aetna Medicare |
$1,036.71
|
Rate for Payer: BCBS Complete |
$673.41
|
Rate for Payer: BCBS MAPPO |
$996.84
|
Rate for Payer: BCBS Trust/PPO |
$640.83
|
Rate for Payer: BCN Commercial |
$1,465.54
|
Rate for Payer: BCN Medicare Advantage |
$996.84
|
Rate for Payer: Cash Price |
$1,744.00
|
Rate for Payer: Cash Price |
$1,744.00
|
Rate for Payer: Cofinity Commercial |
$1,435.45
|
Rate for Payer: Cofinity Commercial |
$1,335.77
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$996.84
|
Rate for Payer: Mclaren Medicaid |
$641.34
|
Rate for Payer: Meridian Medicaid |
$673.41
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,046.68
|
Rate for Payer: PACE SWMI |
$996.84
|
Rate for Payer: PHP Medicare Advantage |
$996.84
|
Rate for Payer: Priority Health Choice Medicaid |
$641.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,526.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,763.34
|
Rate for Payer: Priority Health Medicare |
$996.84
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,763.34
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$996.84
|
Rate for Payer: UHC Dual Complete DSNP |
$996.84
|
Rate for Payer: UHC Medicare Advantage |
$1,026.75
|
|
PR DRAINAGE TENDON SHEATH DIGIT&/PALM EACH
|
Professional
|
Both
|
$750.00
|
|
Service Code
|
HCPCS 26020
|
Min. Negotiated Rate |
$362.31 |
Max. Negotiated Rate |
$860.45 |
Rate for Payer: Aetna Commercial |
$734.28
|
Rate for Payer: Aetna Medicare |
$569.89
|
Rate for Payer: BCBS Complete |
$380.43
|
Rate for Payer: BCBS MAPPO |
$547.97
|
Rate for Payer: BCBS Trust/PPO |
$663.49
|
Rate for Payer: BCN Commercial |
$823.43
|
Rate for Payer: BCN Medicare Advantage |
$547.97
|
Rate for Payer: Cash Price |
$600.00
|
Rate for Payer: Cash Price |
$600.00
|
Rate for Payer: Cofinity Commercial |
$789.08
|
Rate for Payer: Cofinity Commercial |
$734.28
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.97
|
Rate for Payer: Mclaren Medicaid |
$362.31
|
Rate for Payer: Meridian Medicaid |
$380.43
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$575.37
|
Rate for Payer: PACE SWMI |
$547.97
|
Rate for Payer: PHP Medicare Advantage |
$547.97
|
Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
Rate for Payer: Priority Health Cigna Priority Health |
$525.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$860.45
|
Rate for Payer: Priority Health Medicare |
$547.97
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$860.45
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$547.97
|
Rate for Payer: UHC Dual Complete DSNP |
$547.97
|
Rate for Payer: UHC Medicare Advantage |
$564.41
|
|
PR DRESSING CHANGE UNDER ANESTHESIA
|
Professional
|
Both
|
$167.00
|
|
Service Code
|
HCPCS 15852
|
Min. Negotiated Rate |
$28.33 |
Max. Negotiated Rate |
$450.00 |
Rate for Payer: Aetna Commercial |
$61.43
|
Rate for Payer: Aetna Medicare |
$47.67
|
Rate for Payer: BCBS Complete |
$29.75
|
Rate for Payer: BCBS MAPPO |
$45.84
|
Rate for Payer: BCBS Trust/PPO |
$450.00
|
Rate for Payer: BCN Commercial |
$66.95
|
Rate for Payer: BCN Medicare Advantage |
$45.84
|
Rate for Payer: Cash Price |
$133.60
|
Rate for Payer: Cash Price |
$133.60
|
Rate for Payer: Cofinity Commercial |
$66.01
|
Rate for Payer: Cofinity Commercial |
$61.43
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.84
|
Rate for Payer: Mclaren Medicaid |
$28.33
|
Rate for Payer: Meridian Medicaid |
$29.75
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.13
|
Rate for Payer: PACE SWMI |
$45.84
|
Rate for Payer: PHP Medicare Advantage |
$45.84
|
Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
Rate for Payer: Priority Health Cigna Priority Health |
$116.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.32
|
Rate for Payer: Priority Health Medicare |
$45.84
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$56.32
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$45.84
|
Rate for Payer: UHC Dual Complete DSNP |
$45.84
|
Rate for Payer: UHC Medicare Advantage |
$47.22
|
|
PR DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS
|
Professional
|
Both
|
$547.00
|
|
Service Code
|
HCPCS 41800
|
Min. Negotiated Rate |
$99.26 |
Max. Negotiated Rate |
$2,059.31 |
Rate for Payer: Aetna Commercial |
$197.90
|
Rate for Payer: Aetna Medicare |
$153.60
|
Rate for Payer: BCBS Complete |
$104.22
|
Rate for Payer: BCBS MAPPO |
$147.69
|
Rate for Payer: BCBS Trust/PPO |
$2,059.31
|
Rate for Payer: BCN Commercial |
$429.55
|
Rate for Payer: BCN Medicare Advantage |
$147.69
|
Rate for Payer: Cash Price |
$437.60
|
Rate for Payer: Cash Price |
$437.60
|
Rate for Payer: Cofinity Commercial |
$212.67
|
Rate for Payer: Cofinity Commercial |
$197.90
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.69
|
Rate for Payer: Mclaren Medicaid |
$99.26
|
Rate for Payer: Meridian Medicaid |
$104.22
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$155.07
|
Rate for Payer: PACE SWMI |
$147.69
|
Rate for Payer: PHP Medicare Advantage |
$147.69
|
Rate for Payer: Priority Health Choice Medicaid |
$99.26
|
Rate for Payer: Priority Health Cigna Priority Health |
$382.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.65
|
Rate for Payer: Priority Health Medicare |
$147.69
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$271.65
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$147.69
|
Rate for Payer: UHC Dual Complete DSNP |
$147.69
|
Rate for Payer: UHC Medicare Advantage |
$152.12
|
|
PR DRG ABSC CST HMTMA VESTIBULE MOUTH COMP
|
Professional
|
Both
|
$620.00
|
|
Service Code
|
HCPCS 40801
|
Min. Negotiated Rate |
$127.37 |
Max. Negotiated Rate |
$1,779.31 |
Rate for Payer: Aetna Commercial |
$256.23
|
Rate for Payer: Aetna Medicare |
$198.87
|
Rate for Payer: BCBS Complete |
$133.74
|
Rate for Payer: BCBS MAPPO |
$191.22
|
Rate for Payer: BCBS Trust/PPO |
$1,779.31
|
Rate for Payer: BCN Commercial |
$425.15
|
Rate for Payer: BCN Medicare Advantage |
$191.22
|
Rate for Payer: Cash Price |
$496.00
|
Rate for Payer: Cash Price |
$496.00
|
Rate for Payer: Cofinity Commercial |
$275.36
|
Rate for Payer: Cofinity Commercial |
$256.23
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.22
|
Rate for Payer: Mclaren Medicaid |
$127.37
|
Rate for Payer: Meridian Medicaid |
$133.74
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$200.78
|
Rate for Payer: PACE SWMI |
$191.22
|
Rate for Payer: PHP Medicare Advantage |
$191.22
|
Rate for Payer: Priority Health Choice Medicaid |
$127.37
|
Rate for Payer: Priority Health Cigna Priority Health |
$434.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.32
|
Rate for Payer: Priority Health Medicare |
$191.22
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$346.32
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$191.22
|
Rate for Payer: UHC Dual Complete DSNP |
$191.22
|
Rate for Payer: UHC Medicare Advantage |
$196.96
|
|
PR DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV
|
Professional
|
Both
|
$1,037.00
|
|
Service Code
|
HCPCS 38305
|
Min. Negotiated Rate |
$319.50 |
Max. Negotiated Rate |
$1,074.93 |
Rate for Payer: Aetna Commercial |
$653.40
|
Rate for Payer: Aetna Medicare |
$507.11
|
Rate for Payer: BCBS Complete |
$335.48
|
Rate for Payer: BCBS MAPPO |
$487.61
|
Rate for Payer: BCBS Trust/PPO |
$565.81
|
Rate for Payer: BCN Commercial |
$725.20
|
Rate for Payer: BCN Medicare Advantage |
$487.61
|
Rate for Payer: Cash Price |
$829.60
|
Rate for Payer: Cash Price |
$829.60
|
Rate for Payer: Cofinity Commercial |
$653.40
|
Rate for Payer: Cofinity Commercial |
$702.16
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.61
|
Rate for Payer: Mclaren Medicaid |
$319.50
|
Rate for Payer: Meridian Medicaid |
$335.48
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$511.99
|
Rate for Payer: PACE SWMI |
$487.61
|
Rate for Payer: PHP Medicare Advantage |
$487.61
|
Rate for Payer: Priority Health Choice Medicaid |
$319.50
|
Rate for Payer: Priority Health Cigna Priority Health |
$725.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,074.93
|
Rate for Payer: Priority Health Medicare |
$487.61
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,074.93
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$487.61
|
Rate for Payer: UHC Dual Complete DSNP |
$487.61
|
Rate for Payer: UHC Medicare Advantage |
$502.24
|
|
PR DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL
|
Professional
|
Both
|
$446.00
|
|
Service Code
|
HCPCS 38300
|
Min. Negotiated Rate |
$135.47 |
Max. Negotiated Rate |
$604.38 |
Rate for Payer: Aetna Commercial |
$273.75
|
Rate for Payer: Aetna Medicare |
$212.46
|
Rate for Payer: BCBS Complete |
$142.24
|
Rate for Payer: BCBS MAPPO |
$204.29
|
Rate for Payer: BCBS Trust/PPO |
$604.38
|
Rate for Payer: BCN Commercial |
$498.94
|
Rate for Payer: BCN Medicare Advantage |
$204.29
|
Rate for Payer: Cash Price |
$356.80
|
Rate for Payer: Cash Price |
$356.80
|
Rate for Payer: Cofinity Commercial |
$294.18
|
Rate for Payer: Cofinity Commercial |
$273.75
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.29
|
Rate for Payer: Mclaren Medicaid |
$135.47
|
Rate for Payer: Meridian Medicaid |
$142.24
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$214.50
|
Rate for Payer: PACE SWMI |
$204.29
|
Rate for Payer: PHP Medicare Advantage |
$204.29
|
Rate for Payer: Priority Health Choice Medicaid |
$135.47
|
Rate for Payer: Priority Health Cigna Priority Health |
$312.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.88
|
Rate for Payer: Priority Health Medicare |
$204.29
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$454.88
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$204.29
|
Rate for Payer: UHC Dual Complete DSNP |
$204.29
|
Rate for Payer: UHC Medicare Advantage |
$210.42
|
|
PR DRG OF SKENE'S GLAND ABSCESS OR CYST
|
Professional
|
Both
|
$603.00
|
|
Service Code
|
HCPCS 53060
|
Min. Negotiated Rate |
$106.50 |
Max. Negotiated Rate |
$422.10 |
Rate for Payer: Aetna Commercial |
$219.72
|
Rate for Payer: Aetna Medicare |
$170.53
|
Rate for Payer: BCBS Complete |
$111.82
|
Rate for Payer: BCBS MAPPO |
$163.97
|
Rate for Payer: BCBS Trust/PPO |
$283.70
|
Rate for Payer: BCN Commercial |
$277.56
|
Rate for Payer: BCN Medicare Advantage |
$163.97
|
Rate for Payer: Cash Price |
$482.40
|
Rate for Payer: Cash Price |
$482.40
|
Rate for Payer: Cofinity Commercial |
$236.12
|
Rate for Payer: Cofinity Commercial |
$219.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.97
|
Rate for Payer: Mclaren Medicaid |
$106.50
|
Rate for Payer: Meridian Medicaid |
$111.82
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$172.17
|
Rate for Payer: PACE SWMI |
$163.97
|
Rate for Payer: PHP Medicare Advantage |
$163.97
|
Rate for Payer: Priority Health Choice Medicaid |
$106.50
|
Rate for Payer: Priority Health Cigna Priority Health |
$422.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.56
|
Rate for Payer: Priority Health Medicare |
$163.97
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$268.56
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$163.97
|
Rate for Payer: UHC Dual Complete DSNP |
$163.97
|
Rate for Payer: UHC Medicare Advantage |
$168.89
|
|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE
|
Professional
|
Both
|
$303.00
|
|
Service Code
|
HCPCS 16030
|
Min. Negotiated Rate |
$84.14 |
Max. Negotiated Rate |
$569.29 |
Rate for Payer: Aetna Commercial |
$173.15
|
Rate for Payer: Aetna Medicare |
$134.39
|
Rate for Payer: BCBS Complete |
$88.35
|
Rate for Payer: BCBS MAPPO |
$129.22
|
Rate for Payer: BCBS Trust/PPO |
$569.29
|
Rate for Payer: BCN Commercial |
$287.83
|
Rate for Payer: BCN Medicare Advantage |
$129.22
|
Rate for Payer: Cash Price |
$242.40
|
Rate for Payer: Cash Price |
$242.40
|
Rate for Payer: Cofinity Commercial |
$173.15
|
Rate for Payer: Cofinity Commercial |
$186.08
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.22
|
Rate for Payer: Mclaren Medicaid |
$84.14
|
Rate for Payer: Meridian Medicaid |
$88.35
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.68
|
Rate for Payer: PACE SWMI |
$129.22
|
Rate for Payer: PHP Medicare Advantage |
$129.22
|
Rate for Payer: Priority Health Choice Medicaid |
$84.14
|
Rate for Payer: Priority Health Cigna Priority Health |
$212.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.72
|
Rate for Payer: Priority Health Medicare |
$129.22
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$160.72
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$129.22
|
Rate for Payer: UHC Dual Complete DSNP |
$129.22
|
Rate for Payer: UHC Medicare Advantage |
$133.10
|
|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM
|
Professional
|
Both
|
$246.00
|
|
Service Code
|
HCPCS 16025
|
Min. Negotiated Rate |
$71.14 |
Max. Negotiated Rate |
$2,369.57 |
Rate for Payer: Aetna Commercial |
$144.75
|
Rate for Payer: Aetna Medicare |
$112.34
|
Rate for Payer: BCBS Complete |
$74.70
|
Rate for Payer: BCBS MAPPO |
$108.02
|
Rate for Payer: BCBS Trust/PPO |
$2,369.57
|
Rate for Payer: BCN Commercial |
$228.70
|
Rate for Payer: BCN Medicare Advantage |
$108.02
|
Rate for Payer: Cash Price |
$196.80
|
Rate for Payer: Cash Price |
$196.80
|
Rate for Payer: Cofinity Commercial |
$155.55
|
Rate for Payer: Cofinity Commercial |
$144.75
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.02
|
Rate for Payer: Mclaren Medicaid |
$71.14
|
Rate for Payer: Meridian Medicaid |
$74.70
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$113.42
|
Rate for Payer: PACE SWMI |
$108.02
|
Rate for Payer: PHP Medicare Advantage |
$108.02
|
Rate for Payer: Priority Health Choice Medicaid |
$71.14
|
Rate for Payer: Priority Health Cigna Priority Health |
$172.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.82
|
Rate for Payer: Priority Health Medicare |
$108.02
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$134.82
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$108.02
|
Rate for Payer: UHC Dual Complete DSNP |
$108.02
|
Rate for Payer: UHC Medicare Advantage |
$111.26
|
|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL
|
Professional
|
Both
|
$135.00
|
|
Service Code
|
HCPCS 16020
|
Min. Negotiated Rate |
$35.78 |
Max. Negotiated Rate |
$3,995.58 |
Rate for Payer: Aetna Commercial |
$72.02
|
Rate for Payer: Aetna Medicare |
$55.90
|
Rate for Payer: BCBS Complete |
$37.57
|
Rate for Payer: BCBS MAPPO |
$53.75
|
Rate for Payer: BCBS Trust/PPO |
$3,995.58
|
Rate for Payer: BCN Commercial |
$125.10
|
Rate for Payer: BCN Medicare Advantage |
$53.75
|
Rate for Payer: Cash Price |
$108.00
|
Rate for Payer: Cash Price |
$108.00
|
Rate for Payer: Cofinity Commercial |
$72.02
|
Rate for Payer: Cofinity Commercial |
$77.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.75
|
Rate for Payer: Mclaren Medicaid |
$35.78
|
Rate for Payer: Meridian Medicaid |
$37.57
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.44
|
Rate for Payer: PACE SWMI |
$53.75
|
Rate for Payer: PHP Medicare Advantage |
$53.75
|
Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$94.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.82
|
Rate for Payer: Priority Health Medicare |
$53.75
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$67.82
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$53.75
|
Rate for Payer: UHC Dual Complete DSNP |
$53.75
|
Rate for Payer: UHC Medicare Advantage |
$55.36
|
|
PR DRUG-ELUTING STENTS, SINGLE
|
Professional
|
Both
|
$2,475.00
|
|
Service Code
|
HCPCS G0290
|
Min. Negotiated Rate |
$990.00 |
Max. Negotiated Rate |
$1,732.50 |
Rate for Payer: BCBS Complete |
$990.00
|
Rate for Payer: Cash Price |
$1,980.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,732.50
|
|
PR DRUG SCREEN MULTI DRUG CLASS
|
Professional
|
Both
|
$38.00
|
|
Service Code
|
HCPCS G0434
|
Min. Negotiated Rate |
$15.20 |
Max. Negotiated Rate |
$26.60 |
Rate for Payer: BCBS Complete |
$15.20
|
Rate for Payer: Cash Price |
$30.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
|