|
PR ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST
|
Professional
|
Both
|
$3,251.00
|
|
|
Service Code
|
HCPCS 44120
|
| Min. Negotiated Rate |
$236.68 |
| Max. Negotiated Rate |
$2,275.70 |
| Rate for Payer: Aetna Commercial |
$1,626.29
|
| Rate for Payer: Aetna Medicare |
$1,262.20
|
| Rate for Payer: BCBS Complete |
$818.34
|
| Rate for Payer: BCBS MAPPO |
$1,213.65
|
| Rate for Payer: BCBS Trust/PPO |
$236.68
|
| Rate for Payer: BCN Commercial |
$1,778.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,213.65
|
| Rate for Payer: Cash Price |
$2,600.80
|
| Rate for Payer: Cash Price |
$2,600.80
|
| Rate for Payer: Cofinity Commercial |
$1,626.29
|
| Rate for Payer: Cofinity Commercial |
$1,747.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,213.65
|
| Rate for Payer: Mclaren Medicaid |
$779.37
|
| Rate for Payer: Meridian Medicaid |
$818.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,274.33
|
| Rate for Payer: PACE SWMI |
$1,213.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,213.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$779.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,275.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,139.64
|
| Rate for Payer: Priority Health Medicare |
$1,213.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,139.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,213.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,213.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,250.06
|
|
|
PR EO W/O JOINTS CF
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS L3702
|
| Min. Negotiated Rate |
$106.00 |
| Max. Negotiated Rate |
$249.53 |
| Rate for Payer: Aetna Commercial |
$158.29
|
| Rate for Payer: BCBS Complete |
$106.00
|
| Rate for Payer: BCN Commercial |
$249.53
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.50
|
|
|
PR EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN
|
Professional
|
Both
|
$526.00
|
|
|
Service Code
|
HCPCS 93641
|
| Min. Negotiated Rate |
$210.40 |
| Max. Negotiated Rate |
$2,001.73 |
| Rate for Payer: Aetna Commercial |
$765.30
|
| Rate for Payer: BCBS Complete |
$210.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,001.73
|
| Rate for Payer: BCN Commercial |
$835.64
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$807.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$807.65
|
|
|
PR EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS
|
Professional
|
Both
|
$1,700.00
|
|
|
Service Code
|
HCPCS 93642
|
| Min. Negotiated Rate |
$323.02 |
| Max. Negotiated Rate |
$2,287.54 |
| Rate for Payer: Aetna Commercial |
$432.85
|
| Rate for Payer: Aetna Medicare |
$335.94
|
| Rate for Payer: BCBS Complete |
$680.00
|
| Rate for Payer: BCBS MAPPO |
$323.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,287.54
|
| Rate for Payer: BCN Commercial |
$481.35
|
| Rate for Payer: BCN Medicare Advantage |
$323.02
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$465.15
|
| Rate for Payer: Cofinity Commercial |
$432.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$339.17
|
| Rate for Payer: PACE SWMI |
$323.02
|
| Rate for Payer: PHP Medicare Advantage |
$323.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$465.78
|
| Rate for Payer: Priority Health Medicare |
$323.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$465.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.02
|
| Rate for Payer: UHC Medicare Advantage |
$332.71
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/<
|
Professional
|
Both
|
$1,439.00
|
|
|
Service Code
|
HCPCS 15115
|
| Min. Negotiated Rate |
$138.90 |
| Max. Negotiated Rate |
$1,172.34 |
| Rate for Payer: Aetna Commercial |
$907.93
|
| Rate for Payer: Aetna Medicare |
$704.66
|
| Rate for Payer: BCBS Complete |
$467.43
|
| Rate for Payer: BCBS MAPPO |
$677.56
|
| Rate for Payer: BCBS Trust/PPO |
$138.90
|
| Rate for Payer: BCN Commercial |
$1,172.34
|
| Rate for Payer: BCN Medicare Advantage |
$677.56
|
| Rate for Payer: Cash Price |
$1,151.20
|
| Rate for Payer: Cash Price |
$1,151.20
|
| Rate for Payer: Cofinity Commercial |
$975.69
|
| Rate for Payer: Cofinity Commercial |
$907.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$677.56
|
| Rate for Payer: Mclaren Medicaid |
$445.17
|
| Rate for Payer: Meridian Medicaid |
$467.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$711.44
|
| Rate for Payer: PACE SWMI |
$677.56
|
| Rate for Payer: PHP Medicare Advantage |
$677.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,007.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$844.27
|
| Rate for Payer: Priority Health Medicare |
$677.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$844.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$677.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$677.56
|
| Rate for Payer: UHC Medicare Advantage |
$697.89
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 15116
|
| Min. Negotiated Rate |
$87.54 |
| Max. Negotiated Rate |
$281.44 |
| Rate for Payer: Aetna Commercial |
$185.48
|
| Rate for Payer: Aetna Medicare |
$143.96
|
| Rate for Payer: BCBS Complete |
$91.92
|
| Rate for Payer: BCBS MAPPO |
$138.42
|
| Rate for Payer: BCBS Trust/PPO |
$281.44
|
| Rate for Payer: BCN Commercial |
$225.28
|
| Rate for Payer: BCN Medicare Advantage |
$138.42
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$199.32
|
| Rate for Payer: Cofinity Commercial |
$185.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.42
|
| Rate for Payer: Mclaren Medicaid |
$87.54
|
| Rate for Payer: Meridian Medicaid |
$91.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.34
|
| Rate for Payer: PACE SWMI |
$138.42
|
| Rate for Payer: PHP Medicare Advantage |
$138.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.17
|
| Rate for Payer: Priority Health Medicare |
$138.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.42
|
| Rate for Payer: UHC Medicare Advantage |
$142.57
|
|
|
PR EPIDIDYMECTOMY BILATERAL
|
Professional
|
Both
|
$1,051.00
|
|
|
Service Code
|
HCPCS 54861
|
| Min. Negotiated Rate |
$363.59 |
| Max. Negotiated Rate |
$2,782.03 |
| Rate for Payer: Aetna Commercial |
$743.20
|
| Rate for Payer: Aetna Medicare |
$576.82
|
| Rate for Payer: BCBS Complete |
$381.77
|
| Rate for Payer: BCBS MAPPO |
$554.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,782.03
|
| Rate for Payer: BCN Commercial |
$821.46
|
| Rate for Payer: BCN Medicare Advantage |
$554.63
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cofinity Commercial |
$798.67
|
| Rate for Payer: Cofinity Commercial |
$743.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.63
|
| Rate for Payer: Mclaren Medicaid |
$363.59
|
| Rate for Payer: Meridian Medicaid |
$381.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$582.36
|
| Rate for Payer: PACE SWMI |
$554.63
|
| Rate for Payer: PHP Medicare Advantage |
$554.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$735.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.34
|
| Rate for Payer: Priority Health Medicare |
$554.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$908.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$554.63
|
| Rate for Payer: UHC Medicare Advantage |
$571.27
|
|
|
PR EPIDIDYMECTOMY UNILATERAL
|
Professional
|
Both
|
$741.00
|
|
|
Service Code
|
HCPCS 54860
|
| Min. Negotiated Rate |
$268.59 |
| Max. Negotiated Rate |
$1,211.92 |
| Rate for Payer: Aetna Commercial |
$548.02
|
| Rate for Payer: Aetna Medicare |
$425.33
|
| Rate for Payer: BCBS Complete |
$282.02
|
| Rate for Payer: BCBS MAPPO |
$408.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,211.92
|
| Rate for Payer: BCN Commercial |
$606.94
|
| Rate for Payer: BCN Medicare Advantage |
$408.97
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cofinity Commercial |
$588.92
|
| Rate for Payer: Cofinity Commercial |
$548.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.97
|
| Rate for Payer: Mclaren Medicaid |
$268.59
|
| Rate for Payer: Meridian Medicaid |
$282.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$429.42
|
| Rate for Payer: PACE SWMI |
$408.97
|
| Rate for Payer: PHP Medicare Advantage |
$408.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$671.13
|
| Rate for Payer: Priority Health Medicare |
$408.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$671.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$408.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.97
|
| Rate for Payer: UHC Medicare Advantage |
$421.24
|
|
|
PR EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 54900
|
| Min. Negotiated Rate |
$509.28 |
| Max. Negotiated Rate |
$2,046.63 |
| Rate for Payer: Aetna Commercial |
$1,047.56
|
| Rate for Payer: Aetna Medicare |
$813.03
|
| Rate for Payer: BCBS Complete |
$534.74
|
| Rate for Payer: BCBS MAPPO |
$781.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,046.63
|
| Rate for Payer: BCN Commercial |
$1,154.74
|
| Rate for Payer: BCN Medicare Advantage |
$781.76
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,125.73
|
| Rate for Payer: Cofinity Commercial |
$1,047.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.76
|
| Rate for Payer: Mclaren Medicaid |
$509.28
|
| Rate for Payer: Meridian Medicaid |
$534.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$820.85
|
| Rate for Payer: PACE SWMI |
$781.76
|
| Rate for Payer: PHP Medicare Advantage |
$781.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,181.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,276.86
|
| Rate for Payer: Priority Health Medicare |
$781.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,276.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$781.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$781.76
|
| Rate for Payer: UHC Medicare Advantage |
$805.21
|
|
|
PR EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD
|
Professional
|
Both
|
$1,576.00
|
|
|
Service Code
|
HCPCS 15110
|
| Min. Negotiated Rate |
$206.12 |
| Max. Negotiated Rate |
$1,219.74 |
| Rate for Payer: Aetna Commercial |
$940.18
|
| Rate for Payer: Aetna Medicare |
$729.70
|
| Rate for Payer: BCBS Complete |
$480.40
|
| Rate for Payer: BCBS MAPPO |
$701.63
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$1,219.74
|
| Rate for Payer: BCN Medicare Advantage |
$701.63
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cofinity Commercial |
$940.18
|
| Rate for Payer: Cofinity Commercial |
$1,010.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$701.63
|
| Rate for Payer: Mclaren Medicaid |
$457.52
|
| Rate for Payer: Meridian Medicaid |
$480.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$736.71
|
| Rate for Payer: PACE SWMI |
$701.63
|
| Rate for Payer: PHP Medicare Advantage |
$701.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$875.10
|
| Rate for Payer: Priority Health Medicare |
$701.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$875.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$701.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$701.63
|
| Rate for Payer: UHC Medicare Advantage |
$722.68
|
|
|
PR EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 15111
|
| Min. Negotiated Rate |
$64.33 |
| Max. Negotiated Rate |
$212.16 |
| Rate for Payer: Aetna Commercial |
$135.89
|
| Rate for Payer: Aetna Medicare |
$105.47
|
| Rate for Payer: BCBS Complete |
$67.55
|
| Rate for Payer: BCBS MAPPO |
$101.41
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$164.20
|
| Rate for Payer: BCN Medicare Advantage |
$101.41
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$135.89
|
| Rate for Payer: Cofinity Commercial |
$146.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.41
|
| Rate for Payer: Mclaren Medicaid |
$64.33
|
| Rate for Payer: Meridian Medicaid |
$67.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.48
|
| Rate for Payer: PACE SWMI |
$101.41
|
| Rate for Payer: PHP Medicare Advantage |
$101.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.55
|
| Rate for Payer: Priority Health Medicare |
$101.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.41
|
| Rate for Payer: UHC Medicare Advantage |
$104.45
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U
|
Professional
|
Both
|
$1,235.00
|
|
|
Service Code
|
HCPCS 25450
|
| Min. Negotiated Rate |
$402.36 |
| Max. Negotiated Rate |
$3,253.04 |
| Rate for Payer: Aetna Commercial |
$818.28
|
| Rate for Payer: Aetna Medicare |
$635.09
|
| Rate for Payer: BCBS Complete |
$422.48
|
| Rate for Payer: BCBS MAPPO |
$610.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.04
|
| Rate for Payer: BCN Commercial |
$913.83
|
| Rate for Payer: BCN Medicare Advantage |
$610.66
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cofinity Commercial |
$879.35
|
| Rate for Payer: Cofinity Commercial |
$818.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.66
|
| Rate for Payer: Mclaren Medicaid |
$402.36
|
| Rate for Payer: Meridian Medicaid |
$422.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$641.19
|
| Rate for Payer: PACE SWMI |
$610.66
|
| Rate for Payer: PHP Medicare Advantage |
$610.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$954.91
|
| Rate for Payer: Priority Health Medicare |
$610.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$954.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$610.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$610.66
|
| Rate for Payer: UHC Medicare Advantage |
$628.98
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 27185
|
| Min. Negotiated Rate |
$465.83 |
| Max. Negotiated Rate |
$1,108.37 |
| Rate for Payer: Aetna Commercial |
$951.17
|
| Rate for Payer: Aetna Medicare |
$738.22
|
| Rate for Payer: BCBS Complete |
$489.12
|
| Rate for Payer: BCBS MAPPO |
$709.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,108.37
|
| Rate for Payer: BCN Commercial |
$1,059.45
|
| Rate for Payer: BCN Medicare Advantage |
$709.83
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$1,022.16
|
| Rate for Payer: Cofinity Commercial |
$951.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.83
|
| Rate for Payer: Mclaren Medicaid |
$465.83
|
| Rate for Payer: Meridian Medicaid |
$489.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$745.32
|
| Rate for Payer: PACE SWMI |
$709.83
|
| Rate for Payer: PHP Medicare Advantage |
$709.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.08
|
| Rate for Payer: Priority Health Medicare |
$709.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,107.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$709.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.83
|
| Rate for Payer: UHC Medicare Advantage |
$731.12
|
|
|
PR EPISIOTOMY/VAG RPR OTH/THN ATTENDING
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 59300
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$439.02 |
| Rate for Payer: Aetna Commercial |
$197.57
|
| Rate for Payer: Aetna Medicare |
$153.34
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$147.44
|
| Rate for Payer: BCBS Trust/PPO |
$439.02
|
| Rate for Payer: BCN Commercial |
$340.61
|
| Rate for Payer: BCN Medicare Advantage |
$147.44
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cofinity Commercial |
$212.31
|
| Rate for Payer: Cofinity Commercial |
$197.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.44
|
| Rate for Payer: Mclaren Medicaid |
$94.79
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.81
|
| Rate for Payer: PACE SWMI |
$147.44
|
| Rate for Payer: PHP Medicare Advantage |
$147.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.22
|
| Rate for Payer: Priority Health Medicare |
$147.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.44
|
| Rate for Payer: UHC Medicare Advantage |
$151.86
|
|
|
PR EPOETIN ALFA, NON-ESRD
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS J0885
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$26.60 |
| Rate for Payer: Aetna Commercial |
$9.21
|
| Rate for Payer: Aetna Medicare |
$7.15
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$6.88
|
| Rate for Payer: BCBS Trust/PPO |
$6.75
|
| Rate for Payer: BCN Commercial |
$6.02
|
| Rate for Payer: BCN Medicare Advantage |
$6.88
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Commercial |
$9.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.22
|
| Rate for Payer: PACE SWMI |
$6.88
|
| Rate for Payer: PHP Medicare Advantage |
$6.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
| Rate for Payer: Priority Health Medicare |
$6.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.88
|
| Rate for Payer: UHC Medicare Advantage |
$7.08
|
|
|
PR ERCP,ABLATION TUMOR
|
Professional
|
Both
|
$1,623.00
|
|
|
Service Code
|
HCPCS 43272
|
| Min. Negotiated Rate |
$649.20 |
| Max. Negotiated Rate |
$1,136.10 |
| Rate for Payer: BCBS Complete |
$649.20
|
| Rate for Payer: Cash Price |
$1,298.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.10
|
|
|
PR ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA
|
Professional
|
Both
|
$1,162.00
|
|
|
Service Code
|
HCPCS 43277
|
| Min. Negotiated Rate |
$237.07 |
| Max. Negotiated Rate |
$947.77 |
| Rate for Payer: Aetna Commercial |
$491.74
|
| Rate for Payer: Aetna Medicare |
$381.65
|
| Rate for Payer: BCBS Complete |
$248.92
|
| Rate for Payer: BCBS MAPPO |
$366.97
|
| Rate for Payer: BCBS Trust/PPO |
$947.77
|
| Rate for Payer: BCN Commercial |
$540.97
|
| Rate for Payer: BCN Medicare Advantage |
$366.97
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$491.74
|
| Rate for Payer: Cofinity Commercial |
$528.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.97
|
| Rate for Payer: Mclaren Medicaid |
$237.07
|
| Rate for Payer: Meridian Medicaid |
$248.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.32
|
| Rate for Payer: PACE SWMI |
$366.97
|
| Rate for Payer: PHP Medicare Advantage |
$366.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.88
|
| Rate for Payer: Priority Health Medicare |
$366.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$650.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.97
|
| Rate for Payer: UHC Medicare Advantage |
$377.98
|
|
|
PR ERCP,BALLOON DIL DUCTS
|
Professional
|
Both
|
$1,639.00
|
|
|
Service Code
|
HCPCS 43271
|
| Min. Negotiated Rate |
$655.60 |
| Max. Negotiated Rate |
$1,147.30 |
| Rate for Payer: BCBS Complete |
$655.60
|
| Rate for Payer: Cash Price |
$1,311.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.30
|
|
|
PR ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE
|
Professional
|
Both
|
$1,458.00
|
|
|
Service Code
|
HCPCS 43276
|
| Min. Negotiated Rate |
$301.82 |
| Max. Negotiated Rate |
$1,020.60 |
| Rate for Payer: Aetna Commercial |
$626.24
|
| Rate for Payer: Aetna Medicare |
$486.03
|
| Rate for Payer: BCBS Complete |
$316.91
|
| Rate for Payer: BCBS MAPPO |
$467.34
|
| Rate for Payer: BCBS Trust/PPO |
$841.58
|
| Rate for Payer: BCN Commercial |
$688.54
|
| Rate for Payer: BCN Medicare Advantage |
$467.34
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cofinity Commercial |
$626.24
|
| Rate for Payer: Cofinity Commercial |
$672.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.34
|
| Rate for Payer: Mclaren Medicaid |
$301.82
|
| Rate for Payer: Meridian Medicaid |
$316.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$490.71
|
| Rate for Payer: PACE SWMI |
$467.34
|
| Rate for Payer: PHP Medicare Advantage |
$467.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$301.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.45
|
| Rate for Payer: Priority Health Medicare |
$467.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$828.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$467.34
|
| Rate for Payer: UHC Medicare Advantage |
$481.36
|
|
|
PR ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD
|
Professional
|
Both
|
$1,868.00
|
|
|
Service Code
|
HCPCS 43265
|
| Min. Negotiated Rate |
$271.36 |
| Max. Negotiated Rate |
$1,693.20 |
| Rate for Payer: Aetna Commercial |
$562.57
|
| Rate for Payer: Aetna Medicare |
$436.62
|
| Rate for Payer: BCBS Complete |
$284.93
|
| Rate for Payer: BCBS MAPPO |
$419.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.20
|
| Rate for Payer: BCN Commercial |
$618.67
|
| Rate for Payer: BCN Medicare Advantage |
$419.83
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cofinity Commercial |
$604.56
|
| Rate for Payer: Cofinity Commercial |
$562.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.83
|
| Rate for Payer: Mclaren Medicaid |
$271.36
|
| Rate for Payer: Meridian Medicaid |
$284.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$440.82
|
| Rate for Payer: PACE SWMI |
$419.83
|
| Rate for Payer: PHP Medicare Advantage |
$419.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,307.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.37
|
| Rate for Payer: Priority Health Medicare |
$419.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$744.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$419.83
|
| Rate for Payer: UHC Medicare Advantage |
$432.42
|
|
|
PR ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING
|
Professional
|
Both
|
$1,082.00
|
|
|
Service Code
|
HCPCS 43260
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$949.92 |
| Rate for Payer: Aetna Commercial |
$418.76
|
| Rate for Payer: Aetna Medicare |
$325.01
|
| Rate for Payer: BCBS Complete |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$312.51
|
| Rate for Payer: BCBS Trust/PPO |
$949.92
|
| Rate for Payer: BCN Commercial |
$460.83
|
| Rate for Payer: BCN Medicare Advantage |
$312.51
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$418.76
|
| Rate for Payer: Cofinity Commercial |
$450.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.51
|
| Rate for Payer: Mclaren Medicaid |
$202.35
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$328.14
|
| Rate for Payer: PACE SWMI |
$312.51
|
| Rate for Payer: PHP Medicare Advantage |
$312.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.46
|
| Rate for Payer: Priority Health Medicare |
$312.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$554.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.51
|
| Rate for Payer: UHC Medicare Advantage |
$321.89
|
|
|
PR ERCP,INSERT STENT,BILIARY/PANC
|
Professional
|
Both
|
$1,672.00
|
|
|
Service Code
|
HCPCS 43268
|
| Min. Negotiated Rate |
$668.80 |
| Max. Negotiated Rate |
$1,170.40 |
| Rate for Payer: BCBS Complete |
$668.80
|
| Rate for Payer: Cash Price |
$1,337.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,170.40
|
|
|
PR ERCP,NASOBILIARY DRAIN TUBE
|
Professional
|
Both
|
$1,617.00
|
|
|
Service Code
|
HCPCS 43267
|
| Min. Negotiated Rate |
$646.80 |
| Max. Negotiated Rate |
$1,131.90 |
| Rate for Payer: BCBS Complete |
$646.80
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,131.90
|
|
|
PR ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT
|
Professional
|
Both
|
$1,803.00
|
|
|
Service Code
|
HCPCS 43264
|
| Min. Negotiated Rate |
$216.92 |
| Max. Negotiated Rate |
$1,262.10 |
| Rate for Payer: Aetna Commercial |
$473.13
|
| Rate for Payer: Aetna Medicare |
$367.20
|
| Rate for Payer: BCBS Complete |
$239.53
|
| Rate for Payer: BCBS MAPPO |
$353.08
|
| Rate for Payer: BCBS Trust/PPO |
$216.92
|
| Rate for Payer: BCN Commercial |
$520.44
|
| Rate for Payer: BCN Medicare Advantage |
$353.08
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Cofinity Commercial |
$508.44
|
| Rate for Payer: Cofinity Commercial |
$473.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.08
|
| Rate for Payer: Mclaren Medicaid |
$228.12
|
| Rate for Payer: Meridian Medicaid |
$239.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$370.73
|
| Rate for Payer: PACE SWMI |
$353.08
|
| Rate for Payer: PHP Medicare Advantage |
$353.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.19
|
| Rate for Payer: Priority Health Medicare |
$353.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$626.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$353.08
|
| Rate for Payer: UHC Medicare Advantage |
$363.67
|
|
|
PR ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 43275
|
| Min. Negotiated Rate |
$235.79 |
| Max. Negotiated Rate |
$933.51 |
| Rate for Payer: Aetna Commercial |
$488.68
|
| Rate for Payer: Aetna Medicare |
$379.28
|
| Rate for Payer: BCBS Complete |
$247.58
|
| Rate for Payer: BCBS MAPPO |
$364.69
|
| Rate for Payer: BCBS Trust/PPO |
$933.51
|
| Rate for Payer: BCN Commercial |
$537.55
|
| Rate for Payer: BCN Medicare Advantage |
$364.69
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cofinity Commercial |
$525.15
|
| Rate for Payer: Cofinity Commercial |
$488.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.69
|
| Rate for Payer: Mclaren Medicaid |
$235.79
|
| Rate for Payer: Meridian Medicaid |
$247.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$382.92
|
| Rate for Payer: PACE SWMI |
$364.69
|
| Rate for Payer: PHP Medicare Advantage |
$364.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.77
|
| Rate for Payer: Priority Health Medicare |
$364.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$646.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$364.69
|
| Rate for Payer: UHC Medicare Advantage |
$375.63
|
|
