|
PR LAM EXC/OCCLUSION AVM SPINAL CORD CERVICAL
|
Professional
|
Both
|
$4,781.00
|
|
|
Service Code
|
HCPCS 63250
|
| Min. Negotiated Rate |
$331.77 |
| Max. Negotiated Rate |
$5,055.24 |
| Rate for Payer: Aetna Commercial |
$4,003.53
|
| Rate for Payer: Aetna Medicare |
$3,107.22
|
| Rate for Payer: BCBS Complete |
$2,011.96
|
| Rate for Payer: BCBS MAPPO |
$2,987.71
|
| Rate for Payer: BCBS Trust/PPO |
$331.77
|
| Rate for Payer: BCN Commercial |
$4,362.91
|
| Rate for Payer: BCN Medicare Advantage |
$2,987.71
|
| Rate for Payer: Cash Price |
$3,824.80
|
| Rate for Payer: Cash Price |
$3,824.80
|
| Rate for Payer: Cofinity Commercial |
$4,302.30
|
| Rate for Payer: Cofinity Commercial |
$4,003.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,987.71
|
| Rate for Payer: Mclaren Medicaid |
$1,916.15
|
| Rate for Payer: Meridian Medicaid |
$2,011.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,137.10
|
| Rate for Payer: PACE SWMI |
$2,987.71
|
| Rate for Payer: PHP Medicare Advantage |
$2,987.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,916.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,346.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,055.24
|
| Rate for Payer: Priority Health Medicare |
$2,987.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,055.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,987.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,987.71
|
| Rate for Payer: UHC Medicare Advantage |
$3,077.34
|
|
|
PR LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC
|
Professional
|
Both
|
$5,742.00
|
|
|
Service Code
|
HCPCS 63251
|
| Min. Negotiated Rate |
$725.36 |
| Max. Negotiated Rate |
$5,169.05 |
| Rate for Payer: Aetna Commercial |
$4,092.31
|
| Rate for Payer: Aetna Medicare |
$3,176.12
|
| Rate for Payer: BCBS Complete |
$2,057.13
|
| Rate for Payer: BCBS MAPPO |
$3,053.96
|
| Rate for Payer: BCBS Trust/PPO |
$725.36
|
| Rate for Payer: BCN Commercial |
$4,461.14
|
| Rate for Payer: BCN Medicare Advantage |
$3,053.96
|
| Rate for Payer: Cash Price |
$4,593.60
|
| Rate for Payer: Cash Price |
$4,593.60
|
| Rate for Payer: Cofinity Commercial |
$4,397.70
|
| Rate for Payer: Cofinity Commercial |
$4,092.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,053.96
|
| Rate for Payer: Mclaren Medicaid |
$1,959.17
|
| Rate for Payer: Meridian Medicaid |
$2,057.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,206.66
|
| Rate for Payer: PACE SWMI |
$3,053.96
|
| Rate for Payer: PHP Medicare Advantage |
$3,053.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,959.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,019.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,169.05
|
| Rate for Payer: Priority Health Medicare |
$3,053.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,169.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,053.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,053.96
|
| Rate for Payer: UHC Medicare Advantage |
$3,145.58
|
|
|
PR LAM FACETEC/FORAMOT DRG ARTHRD LMBR EA ADDL SGM
|
Professional
|
Both
|
$480.00
|
|
|
Service Code
|
HCPCS 63053
|
| Min. Negotiated Rate |
$146.12 |
| Max. Negotiated Rate |
$385.60 |
| Rate for Payer: Aetna Commercial |
$305.60
|
| Rate for Payer: Aetna Medicare |
$237.18
|
| Rate for Payer: BCBS Complete |
$153.43
|
| Rate for Payer: BCBS MAPPO |
$228.06
|
| Rate for Payer: BCBS Trust/PPO |
$175.40
|
| Rate for Payer: BCN Commercial |
$332.79
|
| Rate for Payer: BCN Medicare Advantage |
$228.06
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cofinity Commercial |
$305.60
|
| Rate for Payer: Cofinity Commercial |
$328.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$228.06
|
| Rate for Payer: Mclaren Medicaid |
$146.12
|
| Rate for Payer: Meridian Medicaid |
$153.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$239.46
|
| Rate for Payer: PACE SWMI |
$228.06
|
| Rate for Payer: PHP Medicare Advantage |
$228.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$385.60
|
| Rate for Payer: Priority Health Medicare |
$228.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$228.06
|
| Rate for Payer: UHC Medicare Advantage |
$234.90
|
|
|
PR LAM FACETEC/FORAMOT DRG ARTHRD LUMBAR 1 VRT SGM
|
Professional
|
Both
|
$640.00
|
|
|
Service Code
|
HCPCS 63052
|
| Min. Negotiated Rate |
$164.44 |
| Max. Negotiated Rate |
$449.06 |
| Rate for Payer: Aetna Commercial |
$345.18
|
| Rate for Payer: Aetna Medicare |
$267.90
|
| Rate for Payer: BCBS Complete |
$172.66
|
| Rate for Payer: BCBS MAPPO |
$257.60
|
| Rate for Payer: BCBS Trust/PPO |
$449.06
|
| Rate for Payer: BCN Commercial |
$375.79
|
| Rate for Payer: BCN Medicare Advantage |
$257.60
|
| Rate for Payer: Cash Price |
$512.00
|
| Rate for Payer: Cash Price |
$512.00
|
| Rate for Payer: Cofinity Commercial |
$345.18
|
| Rate for Payer: Cofinity Commercial |
$370.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.60
|
| Rate for Payer: Mclaren Medicaid |
$164.44
|
| Rate for Payer: Meridian Medicaid |
$172.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.48
|
| Rate for Payer: PACE SWMI |
$257.60
|
| Rate for Payer: PHP Medicare Advantage |
$257.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.42
|
| Rate for Payer: Priority Health Medicare |
$257.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.60
|
| Rate for Payer: UHC Medicare Advantage |
$265.33
|
|
|
PR LAM FACETECTOMY&FORAMOT 1 VRT SGM EA ADDL SGM
|
Professional
|
Both
|
$2,263.00
|
|
|
Service Code
|
HCPCS 63048
|
| Min. Negotiated Rate |
$134.19 |
| Max. Negotiated Rate |
$1,584.10 |
| Rate for Payer: Aetna Commercial |
$280.93
|
| Rate for Payer: Aetna Medicare |
$218.04
|
| Rate for Payer: BCBS Complete |
$140.90
|
| Rate for Payer: BCBS MAPPO |
$209.65
|
| Rate for Payer: BCBS Trust/PPO |
$347.09
|
| Rate for Payer: BCN Commercial |
$336.83
|
| Rate for Payer: BCN Medicare Advantage |
$209.65
|
| Rate for Payer: Cash Price |
$1,810.40
|
| Rate for Payer: Cash Price |
$1,810.40
|
| Rate for Payer: Cofinity Commercial |
$280.93
|
| Rate for Payer: Cofinity Commercial |
$301.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.65
|
| Rate for Payer: Mclaren Medicaid |
$134.19
|
| Rate for Payer: Meridian Medicaid |
$140.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.13
|
| Rate for Payer: PACE SWMI |
$209.65
|
| Rate for Payer: PHP Medicare Advantage |
$209.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,584.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$354.45
|
| Rate for Payer: Priority Health Medicare |
$209.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.65
|
| Rate for Payer: UHC Medicare Advantage |
$215.94
|
|
|
PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM CERVICAL
|
Professional
|
Both
|
$2,625.32
|
|
|
Service Code
|
HCPCS 63045
|
| Min. Negotiated Rate |
$166.94 |
| Max. Negotiated Rate |
$2,199.21 |
| Rate for Payer: Aetna Commercial |
$1,726.16
|
| Rate for Payer: Aetna Medicare |
$1,339.71
|
| Rate for Payer: BCBS Complete |
$876.71
|
| Rate for Payer: BCBS MAPPO |
$1,288.18
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$2,089.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,288.18
|
| Rate for Payer: Cash Price |
$2,100.26
|
| Rate for Payer: Cash Price |
$2,100.26
|
| Rate for Payer: Cofinity Commercial |
$1,854.98
|
| Rate for Payer: Cofinity Commercial |
$1,726.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,288.18
|
| Rate for Payer: Mclaren Medicaid |
$834.96
|
| Rate for Payer: Meridian Medicaid |
$876.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,352.59
|
| Rate for Payer: PACE SWMI |
$1,288.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,288.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$834.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,837.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,199.21
|
| Rate for Payer: Priority Health Medicare |
$1,288.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,199.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,288.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,288.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,326.83
|
|
|
PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR
|
Professional
|
Both
|
$2,240.74
|
|
|
Service Code
|
HCPCS 63047
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$1,886.65 |
| Rate for Payer: Aetna Commercial |
$1,476.52
|
| Rate for Payer: Aetna Medicare |
$1,145.96
|
| Rate for Payer: BCBS Complete |
$751.68
|
| Rate for Payer: BCBS MAPPO |
$1,101.88
|
| Rate for Payer: BCBS Trust/PPO |
$364.00
|
| Rate for Payer: BCN Commercial |
$1,792.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,101.88
|
| Rate for Payer: Cash Price |
$1,792.59
|
| Rate for Payer: Cash Price |
$1,792.59
|
| Rate for Payer: Cofinity Commercial |
$1,476.52
|
| Rate for Payer: Cofinity Commercial |
$1,586.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.88
|
| Rate for Payer: Mclaren Medicaid |
$715.89
|
| Rate for Payer: Meridian Medicaid |
$751.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,156.97
|
| Rate for Payer: PACE SWMI |
$1,101.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,101.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,568.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,886.65
|
| Rate for Payer: Priority Health Medicare |
$1,101.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,886.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,101.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,101.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,134.94
|
|
|
PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM THORACIC
|
Professional
|
Both
|
$2,500.74
|
|
|
Service Code
|
HCPCS 63046
|
| Min. Negotiated Rate |
$189.66 |
| Max. Negotiated Rate |
$2,096.72 |
| Rate for Payer: Aetna Commercial |
$1,643.74
|
| Rate for Payer: Aetna Medicare |
$1,275.74
|
| Rate for Payer: BCBS Complete |
$836.45
|
| Rate for Payer: BCBS MAPPO |
$1,226.67
|
| Rate for Payer: BCBS Trust/PPO |
$189.66
|
| Rate for Payer: BCN Commercial |
$1,992.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,226.67
|
| Rate for Payer: Cash Price |
$2,000.59
|
| Rate for Payer: Cash Price |
$2,000.59
|
| Rate for Payer: Cofinity Commercial |
$1,766.40
|
| Rate for Payer: Cofinity Commercial |
$1,643.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,226.67
|
| Rate for Payer: Mclaren Medicaid |
$796.62
|
| Rate for Payer: Meridian Medicaid |
$836.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,288.00
|
| Rate for Payer: PACE SWMI |
$1,226.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,226.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$796.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,096.72
|
| Rate for Payer: Priority Health Medicare |
$1,226.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,096.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,226.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,226.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,263.47
|
|
|
PR LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL
|
Professional
|
Both
|
$1,686.18
|
|
|
Service Code
|
HCPCS 63655
|
| Min. Negotiated Rate |
$297.43 |
| Max. Negotiated Rate |
$1,433.67 |
| Rate for Payer: Aetna Commercial |
$1,119.50
|
| Rate for Payer: Aetna Medicare |
$868.87
|
| Rate for Payer: BCBS Complete |
$572.54
|
| Rate for Payer: BCBS MAPPO |
$835.45
|
| Rate for Payer: BCBS Trust/PPO |
$297.43
|
| Rate for Payer: BCN Commercial |
$1,362.40
|
| Rate for Payer: BCN Medicare Advantage |
$835.45
|
| Rate for Payer: Cash Price |
$1,348.94
|
| Rate for Payer: Cash Price |
$1,348.94
|
| Rate for Payer: Cofinity Commercial |
$1,203.05
|
| Rate for Payer: Cofinity Commercial |
$1,119.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.45
|
| Rate for Payer: Mclaren Medicaid |
$545.28
|
| Rate for Payer: Meridian Medicaid |
$572.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$877.22
|
| Rate for Payer: PACE SWMI |
$835.45
|
| Rate for Payer: PHP Medicare Advantage |
$835.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$545.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,433.67
|
| Rate for Payer: Priority Health Medicare |
$835.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,433.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$835.45
|
| Rate for Payer: UHC Medicare Advantage |
$860.51
|
|
|
PR LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL
|
Professional
|
Both
|
$6,669.00
|
|
|
Service Code
|
HCPCS 63275
|
| Min. Negotiated Rate |
$191.77 |
| Max. Negotiated Rate |
$4,668.30 |
| Rate for Payer: Aetna Commercial |
$2,436.67
|
| Rate for Payer: Aetna Medicare |
$1,891.15
|
| Rate for Payer: BCBS Complete |
$1,225.15
|
| Rate for Payer: BCBS MAPPO |
$1,818.41
|
| Rate for Payer: BCBS Trust/PPO |
$191.77
|
| Rate for Payer: BCN Commercial |
$2,936.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,818.41
|
| Rate for Payer: Cash Price |
$5,335.20
|
| Rate for Payer: Cash Price |
$5,335.20
|
| Rate for Payer: Cofinity Commercial |
$2,618.51
|
| Rate for Payer: Cofinity Commercial |
$2,436.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,818.41
|
| Rate for Payer: Mclaren Medicaid |
$1,166.81
|
| Rate for Payer: Meridian Medicaid |
$1,225.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,909.33
|
| Rate for Payer: PACE SWMI |
$1,818.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,818.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,166.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,668.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,090.44
|
| Rate for Payer: Priority Health Medicare |
$1,818.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,090.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,818.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,818.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,872.96
|
|
|
PR LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR
|
Professional
|
Both
|
$6,090.00
|
|
|
Service Code
|
HCPCS 63277
|
| Min. Negotiated Rate |
$453.81 |
| Max. Negotiated Rate |
$4,263.00 |
| Rate for Payer: Aetna Commercial |
$2,100.99
|
| Rate for Payer: Aetna Medicare |
$1,630.62
|
| Rate for Payer: BCBS Complete |
$1,061.89
|
| Rate for Payer: BCBS MAPPO |
$1,567.90
|
| Rate for Payer: BCBS Trust/PPO |
$453.81
|
| Rate for Payer: BCN Commercial |
$2,538.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,567.90
|
| Rate for Payer: Cash Price |
$4,872.00
|
| Rate for Payer: Cash Price |
$4,872.00
|
| Rate for Payer: Cofinity Commercial |
$2,100.99
|
| Rate for Payer: Cofinity Commercial |
$2,257.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,567.90
|
| Rate for Payer: Mclaren Medicaid |
$1,011.32
|
| Rate for Payer: Meridian Medicaid |
$1,061.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,646.30
|
| Rate for Payer: PACE SWMI |
$1,567.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,567.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,011.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,263.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,670.88
|
| Rate for Payer: Priority Health Medicare |
$1,567.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,670.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,567.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,567.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,614.94
|
|
|
PR LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL
|
Professional
|
Both
|
$5,298.00
|
|
|
Service Code
|
HCPCS 63278
|
| Min. Negotiated Rate |
$351.32 |
| Max. Negotiated Rate |
$3,708.60 |
| Rate for Payer: Aetna Commercial |
$2,153.26
|
| Rate for Payer: Aetna Medicare |
$1,671.19
|
| Rate for Payer: BCBS Complete |
$1,089.85
|
| Rate for Payer: BCBS MAPPO |
$1,606.91
|
| Rate for Payer: BCBS Trust/PPO |
$351.32
|
| Rate for Payer: BCN Commercial |
$2,597.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,606.91
|
| Rate for Payer: Cash Price |
$4,238.40
|
| Rate for Payer: Cash Price |
$4,238.40
|
| Rate for Payer: Cofinity Commercial |
$2,313.95
|
| Rate for Payer: Cofinity Commercial |
$2,153.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,606.91
|
| Rate for Payer: Mclaren Medicaid |
$1,037.95
|
| Rate for Payer: Meridian Medicaid |
$1,089.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,687.26
|
| Rate for Payer: PACE SWMI |
$1,606.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,606.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,037.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,708.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,733.17
|
| Rate for Payer: Priority Health Medicare |
$1,606.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,733.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,606.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,606.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,655.12
|
|
|
PR LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC
|
Professional
|
Both
|
$6,788.00
|
|
|
Service Code
|
HCPCS 63276
|
| Min. Negotiated Rate |
$311.70 |
| Max. Negotiated Rate |
$4,751.60 |
| Rate for Payer: Aetna Commercial |
$2,407.42
|
| Rate for Payer: Aetna Medicare |
$1,868.44
|
| Rate for Payer: BCBS Complete |
$1,217.55
|
| Rate for Payer: BCBS MAPPO |
$1,796.58
|
| Rate for Payer: BCBS Trust/PPO |
$311.70
|
| Rate for Payer: BCN Commercial |
$2,902.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,796.58
|
| Rate for Payer: Cash Price |
$5,430.40
|
| Rate for Payer: Cash Price |
$5,430.40
|
| Rate for Payer: Cofinity Commercial |
$2,587.08
|
| Rate for Payer: Cofinity Commercial |
$2,407.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,796.58
|
| Rate for Payer: Mclaren Medicaid |
$1,159.57
|
| Rate for Payer: Meridian Medicaid |
$1,217.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,886.41
|
| Rate for Payer: PACE SWMI |
$1,796.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,796.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,159.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,751.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,054.22
|
| Rate for Payer: Priority Health Medicare |
$1,796.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,054.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,796.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,796.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.48
|
|
|
PR LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR
|
Professional
|
Both
|
$5,800.00
|
|
|
Service Code
|
HCPCS 63200
|
| Min. Negotiated Rate |
$291.09 |
| Max. Negotiated Rate |
$4,060.00 |
| Rate for Payer: Aetna Commercial |
$2,052.50
|
| Rate for Payer: Aetna Medicare |
$1,592.99
|
| Rate for Payer: BCBS Complete |
$1,046.01
|
| Rate for Payer: BCBS MAPPO |
$1,531.72
|
| Rate for Payer: BCBS Trust/PPO |
$291.09
|
| Rate for Payer: BCN Commercial |
$2,479.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,531.72
|
| Rate for Payer: Cash Price |
$4,640.00
|
| Rate for Payer: Cash Price |
$4,640.00
|
| Rate for Payer: Cofinity Commercial |
$2,052.50
|
| Rate for Payer: Cofinity Commercial |
$2,205.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,531.72
|
| Rate for Payer: Mclaren Medicaid |
$996.20
|
| Rate for Payer: Meridian Medicaid |
$1,046.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,608.31
|
| Rate for Payer: PACE SWMI |
$1,531.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,531.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,060.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,609.15
|
| Rate for Payer: Priority Health Medicare |
$1,531.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,609.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,531.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,531.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,577.67
|
|
|
PR LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR
|
Professional
|
Both
|
$4,934.00
|
|
|
Service Code
|
HCPCS 63005
|
| Min. Negotiated Rate |
$233.48 |
| Max. Negotiated Rate |
$3,453.80 |
| Rate for Payer: Aetna Commercial |
$1,607.32
|
| Rate for Payer: Aetna Medicare |
$1,247.47
|
| Rate for Payer: BCBS Complete |
$818.56
|
| Rate for Payer: BCBS MAPPO |
$1,199.49
|
| Rate for Payer: BCBS Trust/PPO |
$233.48
|
| Rate for Payer: BCN Commercial |
$1,947.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,199.49
|
| Rate for Payer: Cash Price |
$3,947.20
|
| Rate for Payer: Cash Price |
$3,947.20
|
| Rate for Payer: Cofinity Commercial |
$1,607.32
|
| Rate for Payer: Cofinity Commercial |
$1,727.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,199.49
|
| Rate for Payer: Mclaren Medicaid |
$779.58
|
| Rate for Payer: Meridian Medicaid |
$818.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,259.46
|
| Rate for Payer: PACE SWMI |
$1,199.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,199.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$779.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,453.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,049.17
|
| Rate for Payer: Priority Health Medicare |
$1,199.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,049.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,199.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,199.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,235.47
|
|
|
PR LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL
|
Professional
|
Both
|
$2,197.00
|
|
|
Service Code
|
HCPCS 63011
|
| Min. Negotiated Rate |
$449.06 |
| Max. Negotiated Rate |
$1,861.74 |
| Rate for Payer: Aetna Commercial |
$1,455.78
|
| Rate for Payer: Aetna Medicare |
$1,129.86
|
| Rate for Payer: BCBS Complete |
$738.27
|
| Rate for Payer: BCBS MAPPO |
$1,086.40
|
| Rate for Payer: BCBS Trust/PPO |
$449.06
|
| Rate for Payer: BCN Commercial |
$1,606.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,086.40
|
| Rate for Payer: Cash Price |
$1,757.60
|
| Rate for Payer: Cash Price |
$1,757.60
|
| Rate for Payer: Cofinity Commercial |
$1,455.78
|
| Rate for Payer: Cofinity Commercial |
$1,564.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,086.40
|
| Rate for Payer: Mclaren Medicaid |
$703.11
|
| Rate for Payer: Meridian Medicaid |
$738.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,140.72
|
| Rate for Payer: PACE SWMI |
$1,086.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,086.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,861.74
|
| Rate for Payer: Priority Health Medicare |
$1,086.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,861.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,086.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,118.99
|
|
|
PR LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC
|
Professional
|
Both
|
$6,062.00
|
|
|
Service Code
|
HCPCS 63003
|
| Min. Negotiated Rate |
$194.94 |
| Max. Negotiated Rate |
$4,243.40 |
| Rate for Payer: Aetna Commercial |
$1,657.70
|
| Rate for Payer: Aetna Medicare |
$1,286.57
|
| Rate for Payer: BCBS Complete |
$840.47
|
| Rate for Payer: BCBS MAPPO |
$1,237.09
|
| Rate for Payer: BCBS Trust/PPO |
$194.94
|
| Rate for Payer: BCN Commercial |
$2,002.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.09
|
| Rate for Payer: Cash Price |
$4,849.60
|
| Rate for Payer: Cash Price |
$4,849.60
|
| Rate for Payer: Cofinity Commercial |
$1,781.41
|
| Rate for Payer: Cofinity Commercial |
$1,657.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.09
|
| Rate for Payer: Mclaren Medicaid |
$800.45
|
| Rate for Payer: Meridian Medicaid |
$840.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,298.94
|
| Rate for Payer: PACE SWMI |
$1,237.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$800.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,243.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,107.48
|
| Rate for Payer: Priority Health Medicare |
$1,237.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,107.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,237.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,237.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,274.20
|
|
|
PR LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL
|
Professional
|
Both
|
$6,133.00
|
|
|
Service Code
|
HCPCS 63015
|
| Min. Negotiated Rate |
$422.11 |
| Max. Negotiated Rate |
$4,293.10 |
| Rate for Payer: Aetna Commercial |
$1,989.87
|
| Rate for Payer: Aetna Medicare |
$1,544.38
|
| Rate for Payer: BCBS Complete |
$1,009.33
|
| Rate for Payer: BCBS MAPPO |
$1,484.98
|
| Rate for Payer: BCBS Trust/PPO |
$422.11
|
| Rate for Payer: BCN Commercial |
$2,404.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,484.98
|
| Rate for Payer: Cash Price |
$4,906.40
|
| Rate for Payer: Cash Price |
$4,906.40
|
| Rate for Payer: Cofinity Commercial |
$1,989.87
|
| Rate for Payer: Cofinity Commercial |
$2,138.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,484.98
|
| Rate for Payer: Mclaren Medicaid |
$961.27
|
| Rate for Payer: Meridian Medicaid |
$1,009.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,559.23
|
| Rate for Payer: PACE SWMI |
$1,484.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,484.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$961.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,293.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,529.89
|
| Rate for Payer: Priority Health Medicare |
$1,484.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,529.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,484.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,484.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,529.53
|
|
|
PR LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR
|
Professional
|
Both
|
$6,135.00
|
|
|
Service Code
|
HCPCS 63017
|
| Min. Negotiated Rate |
$263.09 |
| Max. Negotiated Rate |
$4,294.50 |
| Rate for Payer: Aetna Commercial |
$1,699.35
|
| Rate for Payer: Aetna Medicare |
$1,318.90
|
| Rate for Payer: BCBS Complete |
$863.07
|
| Rate for Payer: BCBS MAPPO |
$1,268.17
|
| Rate for Payer: BCBS Trust/PPO |
$263.09
|
| Rate for Payer: BCN Commercial |
$2,056.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,268.17
|
| Rate for Payer: Cash Price |
$4,908.00
|
| Rate for Payer: Cash Price |
$4,908.00
|
| Rate for Payer: Cofinity Commercial |
$1,826.16
|
| Rate for Payer: Cofinity Commercial |
$1,699.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,268.17
|
| Rate for Payer: Mclaren Medicaid |
$821.97
|
| Rate for Payer: Meridian Medicaid |
$863.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,331.58
|
| Rate for Payer: PACE SWMI |
$1,268.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,268.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,294.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,164.11
|
| Rate for Payer: Priority Health Medicare |
$1,268.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,164.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,268.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,306.22
|
|
|
PR LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC
|
Professional
|
Both
|
$6,640.00
|
|
|
Service Code
|
HCPCS 63016
|
| Min. Negotiated Rate |
$313.28 |
| Max. Negotiated Rate |
$4,648.00 |
| Rate for Payer: Aetna Commercial |
$2,054.89
|
| Rate for Payer: Aetna Medicare |
$1,594.84
|
| Rate for Payer: BCBS Complete |
$1,037.74
|
| Rate for Payer: BCBS MAPPO |
$1,533.50
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$2,480.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,533.50
|
| Rate for Payer: Cash Price |
$5,312.00
|
| Rate for Payer: Cash Price |
$5,312.00
|
| Rate for Payer: Cofinity Commercial |
$2,208.24
|
| Rate for Payer: Cofinity Commercial |
$2,054.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,533.50
|
| Rate for Payer: Mclaren Medicaid |
$988.32
|
| Rate for Payer: Meridian Medicaid |
$1,037.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,610.18
|
| Rate for Payer: PACE SWMI |
$1,533.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,533.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$988.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,648.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,610.29
|
| Rate for Payer: Priority Health Medicare |
$1,533.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,610.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,533.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,533.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,579.50
|
|
|
PR LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS
|
Professional
|
Both
|
$5,671.00
|
|
|
Service Code
|
HCPCS 63185
|
| Min. Negotiated Rate |
$801.95 |
| Max. Negotiated Rate |
$4,716.13 |
| Rate for Payer: Aetna Commercial |
$1,523.24
|
| Rate for Payer: Aetna Medicare |
$1,182.22
|
| Rate for Payer: BCBS Complete |
$842.05
|
| Rate for Payer: BCBS MAPPO |
$1,136.75
|
| Rate for Payer: BCBS Trust/PPO |
$4,716.13
|
| Rate for Payer: BCN Commercial |
$1,680.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,136.75
|
| Rate for Payer: Cash Price |
$4,536.80
|
| Rate for Payer: Cash Price |
$4,536.80
|
| Rate for Payer: Cofinity Commercial |
$1,523.24
|
| Rate for Payer: Cofinity Commercial |
$1,636.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,136.75
|
| Rate for Payer: Mclaren Medicaid |
$801.95
|
| Rate for Payer: Meridian Medicaid |
$842.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,193.59
|
| Rate for Payer: PACE SWMI |
$1,136.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,136.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,969.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,946.67
|
| Rate for Payer: Priority Health Medicare |
$1,136.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,946.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,136.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,136.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,170.85
|
|
|
PR LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR
|
Professional
|
Both
|
$6,034.00
|
|
|
Service Code
|
HCPCS 63012
|
| Min. Negotiated Rate |
$479.17 |
| Max. Negotiated Rate |
$4,223.80 |
| Rate for Payer: Aetna Commercial |
$1,602.21
|
| Rate for Payer: Aetna Medicare |
$1,243.51
|
| Rate for Payer: BCBS Complete |
$812.07
|
| Rate for Payer: BCBS MAPPO |
$1,195.68
|
| Rate for Payer: BCBS Trust/PPO |
$479.17
|
| Rate for Payer: BCN Commercial |
$1,940.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,195.68
|
| Rate for Payer: Cash Price |
$4,827.20
|
| Rate for Payer: Cash Price |
$4,827.20
|
| Rate for Payer: Cofinity Commercial |
$1,602.21
|
| Rate for Payer: Cofinity Commercial |
$1,721.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,195.68
|
| Rate for Payer: Mclaren Medicaid |
$773.40
|
| Rate for Payer: Meridian Medicaid |
$812.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,255.46
|
| Rate for Payer: PACE SWMI |
$1,195.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,195.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$773.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,223.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,041.80
|
| Rate for Payer: Priority Health Medicare |
$1,195.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,041.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,195.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,195.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,231.55
|
|
|
PR LAMINECTOMY W/SECTION SPINAL ACCESSORY NERVE
|
Professional
|
Both
|
$2,188.00
|
|
|
Service Code
|
HCPCS 63191
|
| Min. Negotiated Rate |
$243.55 |
| Max. Negotiated Rate |
$2,369.65 |
| Rate for Payer: Aetna Commercial |
$1,865.01
|
| Rate for Payer: Aetna Medicare |
$1,447.47
|
| Rate for Payer: BCBS Complete |
$945.37
|
| Rate for Payer: BCBS MAPPO |
$1,391.80
|
| Rate for Payer: BCBS Trust/PPO |
$243.55
|
| Rate for Payer: BCN Commercial |
$2,045.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,391.80
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cofinity Commercial |
$2,004.19
|
| Rate for Payer: Cofinity Commercial |
$1,865.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,391.80
|
| Rate for Payer: Mclaren Medicaid |
$900.35
|
| Rate for Payer: Meridian Medicaid |
$945.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,461.39
|
| Rate for Payer: PACE SWMI |
$1,391.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,391.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$900.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,531.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,369.65
|
| Rate for Payer: Priority Health Medicare |
$1,391.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,369.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,391.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,391.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,433.55
|
|
|
PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC
|
Professional
|
Both
|
$5,633.00
|
|
|
Service Code
|
HCPCS 63020
|
| Min. Negotiated Rate |
$230.34 |
| Max. Negotiated Rate |
$3,943.10 |
| Rate for Payer: Aetna Commercial |
$1,462.97
|
| Rate for Payer: Aetna Medicare |
$1,135.44
|
| Rate for Payer: BCBS Complete |
$746.99
|
| Rate for Payer: BCBS MAPPO |
$1,091.77
|
| Rate for Payer: BCBS Trust/PPO |
$230.34
|
| Rate for Payer: BCN Commercial |
$1,778.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,091.77
|
| Rate for Payer: Cash Price |
$4,506.40
|
| Rate for Payer: Cash Price |
$4,506.40
|
| Rate for Payer: Cofinity Commercial |
$1,462.97
|
| Rate for Payer: Cofinity Commercial |
$1,572.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,091.77
|
| Rate for Payer: Mclaren Medicaid |
$711.42
|
| Rate for Payer: Meridian Medicaid |
$746.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,146.36
|
| Rate for Payer: PACE SWMI |
$1,091.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,091.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$711.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,943.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,871.37
|
| Rate for Payer: Priority Health Medicare |
$1,091.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,871.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,091.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,091.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,124.52
|
|
|
PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR
|
Professional
|
Both
|
$5,455.00
|
|
|
Service Code
|
HCPCS 63030
|
| Min. Negotiated Rate |
$318.04 |
| Max. Negotiated Rate |
$3,818.50 |
| Rate for Payer: Aetna Commercial |
$1,215.66
|
| Rate for Payer: Aetna Medicare |
$943.50
|
| Rate for Payer: BCBS Complete |
$622.87
|
| Rate for Payer: BCBS MAPPO |
$907.21
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$1,146.75
|
| Rate for Payer: BCN Medicare Advantage |
$907.21
|
| Rate for Payer: Cash Price |
$4,364.00
|
| Rate for Payer: Cash Price |
$4,364.00
|
| Rate for Payer: Cofinity Commercial |
$1,306.38
|
| Rate for Payer: Cofinity Commercial |
$1,215.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$907.21
|
| Rate for Payer: Mclaren Medicaid |
$593.21
|
| Rate for Payer: Meridian Medicaid |
$622.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$952.57
|
| Rate for Payer: PACE SWMI |
$907.21
|
| Rate for Payer: PHP Medicare Advantage |
$907.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,818.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,558.81
|
| Rate for Payer: Priority Health Medicare |
$907.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,558.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$907.21
|
| Rate for Payer: UHC Medicare Advantage |
$934.43
|
|
