|
PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 60100
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna Commercial |
$99.74
|
| Rate for Payer: Aetna Medicare |
$111.00
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCN Commercial |
$112.55
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Mclaren Medicaid |
$41.75
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$122.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.03
|
| Rate for Payer: UHC Medicaid |
$41.75
|
| Rate for Payer: UHCCP Medicaid |
$41.75
|
|
|
PR BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 41100
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$140.82
|
| Rate for Payer: Aetna Medicare |
$169.00
|
| Rate for Payer: BCBS Complete |
$65.31
|
| Rate for Payer: BCN Commercial |
$162.34
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Mclaren Medicaid |
$62.20
|
| Rate for Payer: Meridian Medicaid |
$65.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$197.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.80
|
| Rate for Payer: UHC Medicaid |
$62.20
|
| Rate for Payer: UHCCP Medicaid |
$62.20
|
|
|
PR BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 41105
|
| Min. Negotiated Rate |
$64.11 |
| Max. Negotiated Rate |
$234.75 |
| Rate for Payer: Aetna Commercial |
$144.46
|
| Rate for Payer: Aetna Medicare |
$156.50
|
| Rate for Payer: BCBS Complete |
$67.32
|
| Rate for Payer: BCN Commercial |
$166.82
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Mclaren Medicaid |
$64.11
|
| Rate for Payer: Meridian Medicaid |
$67.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.26
|
| Rate for Payer: UHC Medicaid |
$64.11
|
| Rate for Payer: UHCCP Medicaid |
$64.11
|
|
|
PR BIOPSY URETHRA
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 53200
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$298.50 |
| Rate for Payer: Aetna Commercial |
$181.70
|
| Rate for Payer: Aetna Medicare |
$199.00
|
| Rate for Payer: BCBS Complete |
$85.66
|
| Rate for Payer: BCN Commercial |
$212.14
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Mclaren Medicaid |
$81.58
|
| Rate for Payer: Meridian Medicaid |
$85.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$231.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.10
|
| Rate for Payer: UHC Medicaid |
$81.58
|
| Rate for Payer: UHCCP Medicaid |
$81.58
|
|
|
PR BIOPSY VAGINAL MUCOSA EXTENSIVE
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 57105
|
| Min. Negotiated Rate |
$86.48 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Commercial |
$167.82
|
| Rate for Payer: Aetna Medicare |
$162.50
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCN Commercial |
$220.11
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Mclaren Medicaid |
$86.48
|
| Rate for Payer: Meridian Medicaid |
$90.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$222.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.92
|
| Rate for Payer: UHC Medicaid |
$86.48
|
| Rate for Payer: UHCCP Medicaid |
$86.48
|
|
|
PR BIOPSY VAGINAL MUCOSA SIMPLE
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 57100
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Aetna Commercial |
$78.63
|
| Rate for Payer: Aetna Medicare |
$87.00
|
| Rate for Payer: BCBS Complete |
$39.14
|
| Rate for Payer: BCN Commercial |
$98.10
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Mclaren Medicaid |
$37.28
|
| Rate for Payer: Meridian Medicaid |
$39.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.35
|
| Rate for Payer: UHC Medicaid |
$37.28
|
| Rate for Payer: UHCCP Medicaid |
$37.28
|
|
|
PR BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS 20251
|
| Min. Negotiated Rate |
$268.59 |
| Max. Negotiated Rate |
$1,025.25 |
| Rate for Payer: Aetna Commercial |
$569.56
|
| Rate for Payer: Aetna Medicare |
$683.50
|
| Rate for Payer: BCBS Complete |
$282.02
|
| Rate for Payer: BCN Commercial |
$654.35
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Mclaren Medicaid |
$268.59
|
| Rate for Payer: Meridian Medicaid |
$282.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$699.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$699.47
|
| Rate for Payer: UHC Medicaid |
$268.59
|
| Rate for Payer: UHCCP Medicaid |
$268.59
|
|
|
PR BIOPSY VERTEBRAL BODY OPEN THORACIC
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 20250
|
| Min. Negotiated Rate |
$247.08 |
| Max. Negotiated Rate |
$636.13 |
| Rate for Payer: Aetna Commercial |
$521.70
|
| Rate for Payer: Aetna Medicare |
$413.50
|
| Rate for Payer: BCBS Complete |
$259.43
|
| Rate for Payer: BCN Commercial |
$595.09
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Mclaren Medicaid |
$247.08
|
| Rate for Payer: Meridian Medicaid |
$259.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$636.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.13
|
| Rate for Payer: UHC Medicaid |
$247.08
|
| Rate for Payer: UHCCP Medicaid |
$247.08
|
|
|
PR BIOPSY VESTIBULE MOUTH
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 40808
|
| Min. Negotiated Rate |
$52.61 |
| Max. Negotiated Rate |
$235.50 |
| Rate for Payer: Aetna Commercial |
$113.82
|
| Rate for Payer: Aetna Medicare |
$157.00
|
| Rate for Payer: BCBS Complete |
$55.24
|
| Rate for Payer: BCN Commercial |
$135.95
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Mclaren Medicaid |
$52.61
|
| Rate for Payer: Meridian Medicaid |
$55.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$165.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.65
|
| Rate for Payer: UHC Medicaid |
$52.61
|
| Rate for Payer: UHCCP Medicaid |
$52.61
|
|
|
PR BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 56605
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$235.50 |
| Rate for Payer: Aetna Commercial |
$70.93
|
| Rate for Payer: Aetna Medicare |
$157.00
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCN Commercial |
$69.51
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Mclaren Medicaid |
$33.02
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$89.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.26
|
| Rate for Payer: UHC Medicaid |
$33.02
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
|
|
PR BIOPSY VULVA/PERINEUM EACH ADDL LESION
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 56606
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Aetna Commercial |
$35.11
|
| Rate for Payer: Aetna Medicare |
$99.00
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.38
|
| Rate for Payer: UHC Medicaid |
$16.19
|
| Rate for Payer: UHCCP Medicaid |
$16.19
|
|
|
PR BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 33933
|
| Min. Negotiated Rate |
$251.71 |
| Max. Negotiated Rate |
$684.39 |
| Rate for Payer: Aetna Commercial |
$536.72
|
| Rate for Payer: Aetna Medicare |
$347.00
|
| Rate for Payer: BCBS Complete |
$264.30
|
| Rate for Payer: BCN Commercial |
$633.90
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Mclaren Medicaid |
$251.71
|
| Rate for Payer: Meridian Medicaid |
$264.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$684.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.39
|
| Rate for Payer: UHC Medicaid |
$251.71
|
| Rate for Payer: UHCCP Medicaid |
$251.71
|
|
|
PR BLADDER INSTILLATION ANTICARCINOGENIC AGENT
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
HCPCS 51720
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$56.30
|
| Rate for Payer: Aetna Medicare |
$140.00
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCN Commercial |
$51.44
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Mclaren Medicaid |
$24.28
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.06
|
| Rate for Payer: UHC Medicaid |
$24.28
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
|
|
PR BLADDER PRESSURE MEASUREMENT DURING FILLING
|
Professional
|
Both
|
$721.00
|
|
|
Service Code
|
HCPCS 51726
|
| Min. Negotiated Rate |
$360.50 |
| Max. Negotiated Rate |
$540.75 |
| Rate for Payer: Aetna Commercial |
$380.17
|
| Rate for Payer: Aetna Medicare |
$360.50
|
| Rate for Payer: BCN Commercial |
$414.32
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$540.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$451.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$451.32
|
|
|
PR BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 38206
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$356.25 |
| Rate for Payer: Aetna Commercial |
$104.26
|
| Rate for Payer: Aetna Medicare |
$237.50
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Mclaren Medicaid |
$43.03
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$356.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$161.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.68
|
| Rate for Payer: UHC Medicaid |
$43.03
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
|
|
PR BLDR IRRIGATION SMPL LAVAGE &/INSTLJ
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 51700
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$135.75 |
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna Medicare |
$90.50
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCN Commercial |
$34.95
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Mclaren Medicaid |
$16.61
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.28
|
| Rate for Payer: UHC Medicaid |
$16.61
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
|
|
PR BLEPHAROPLASTY LOWER EYELID W/HERNIATED FAT PAD
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 15821
|
| Min. Negotiated Rate |
$308.42 |
| Max. Negotiated Rate |
$820.67 |
| Rate for Payer: Aetna Commercial |
$582.43
|
| Rate for Payer: Aetna Medicare |
$473.00
|
| Rate for Payer: BCBS Complete |
$323.84
|
| Rate for Payer: BCN Commercial |
$820.67
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Mclaren Medicaid |
$308.42
|
| Rate for Payer: Meridian Medicaid |
$323.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$751.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$751.13
|
| Rate for Payer: UHC Medicaid |
$308.42
|
| Rate for Payer: UHCCP Medicaid |
$308.42
|
|
|
PR BLEPHAROPLASTY UPPER EYELID
|
Professional
|
Both
|
$972.00
|
|
|
Service Code
|
HCPCS 15822
|
| Min. Negotiated Rate |
$226.85 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Aetna Commercial |
$422.37
|
| Rate for Payer: Aetna Medicare |
$486.00
|
| Rate for Payer: BCBS Complete |
$238.19
|
| Rate for Payer: BCN Commercial |
$595.09
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Mclaren Medicaid |
$226.85
|
| Rate for Payer: Meridian Medicaid |
$238.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$729.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$544.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$544.66
|
| Rate for Payer: UHC Medicaid |
$226.85
|
| Rate for Payer: UHCCP Medicaid |
$226.85
|
|
|
PR BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 15823
|
| Min. Negotiated Rate |
$307.15 |
| Max. Negotiated Rate |
$820.67 |
| Rate for Payer: Aetna Commercial |
$584.27
|
| Rate for Payer: Aetna Medicare |
$473.00
|
| Rate for Payer: BCBS Complete |
$322.51
|
| Rate for Payer: BCN Commercial |
$820.67
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Mclaren Medicaid |
$307.15
|
| Rate for Payer: Meridian Medicaid |
$322.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$751.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$751.13
|
| Rate for Payer: UHC Medicaid |
$307.15
|
| Rate for Payer: UHCCP Medicaid |
$307.15
|
|
|
PR BLEPHAROTOMY DRAINAGE ABSCESS EYELID
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
HCPCS 67700
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: Aetna Commercial |
$149.98
|
| Rate for Payer: Aetna Medicare |
$228.00
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCN Commercial |
$173.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Mclaren Medicaid |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$342.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.58
|
| Rate for Payer: UHC Medicaid |
$65.39
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
|
|
PR BLUE TIDAL
|
Professional
|
Both
|
$63.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Aetna Medicare |
$31.50
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR BONE GRAFT ANY DONOR AREA MAJOR/LARGE
|
Professional
|
Both
|
$1,291.00
|
|
|
Service Code
|
HCPCS 20902
|
| Min. Negotiated Rate |
$154.21 |
| Max. Negotiated Rate |
$968.25 |
| Rate for Payer: Aetna Commercial |
$373.38
|
| Rate for Payer: Aetna Medicare |
$645.50
|
| Rate for Payer: BCBS Complete |
$161.92
|
| Rate for Payer: BCN Commercial |
$409.84
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Mclaren Medicaid |
$154.21
|
| Rate for Payer: Meridian Medicaid |
$161.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$968.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$438.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$438.10
|
| Rate for Payer: UHC Medicaid |
$154.21
|
| Rate for Payer: UHCCP Medicaid |
$154.21
|
|
|
PR BONE GRAFT ANY DONOR AREA MINOR/SMALL
|
Professional
|
Both
|
$936.00
|
|
|
Service Code
|
HCPCS 20900
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$702.00 |
| Rate for Payer: Aetna Commercial |
$244.23
|
| Rate for Payer: Aetna Medicare |
$468.00
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCN Commercial |
$269.91
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Mclaren Medicaid |
$102.45
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$288.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.52
|
| Rate for Payer: UHC Medicaid |
$102.45
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR
|
Professional
|
Both
|
$4,726.00
|
|
|
Service Code
|
HCPCS 20962
|
| Min. Negotiated Rate |
$1,548.51 |
| Max. Negotiated Rate |
$4,301.74 |
| Rate for Payer: Aetna Commercial |
$3,549.97
|
| Rate for Payer: Aetna Medicare |
$2,363.00
|
| Rate for Payer: BCBS Complete |
$1,625.94
|
| Rate for Payer: BCN Commercial |
$4,024.18
|
| Rate for Payer: Cash Price |
$3,780.80
|
| Rate for Payer: Cash Price |
$3,780.80
|
| Rate for Payer: Mclaren Medicaid |
$1,548.51
|
| Rate for Payer: Meridian Medicaid |
$1,625.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,544.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,548.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,301.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,301.74
|
| Rate for Payer: UHC Medicaid |
$1,548.51
|
| Rate for Payer: UHCCP Medicaid |
$1,548.51
|
|
|
PR BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 20939
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$111.79 |
| Rate for Payer: Aetna Commercial |
$93.83
|
| Rate for Payer: Aetna Medicare |
$74.50
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCN Commercial |
$104.58
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Mclaren Medicaid |
$39.19
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$111.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.79
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
