|
PR LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY
|
Professional
|
Both
|
$2,718.00
|
|
|
Service Code
|
HCPCS 58571
|
| Min. Negotiated Rate |
$74.49 |
| Max. Negotiated Rate |
$1,902.60 |
| Rate for Payer: Aetna Commercial |
$1,204.32
|
| Rate for Payer: Aetna Medicare |
$934.70
|
| Rate for Payer: BCBS Complete |
$613.47
|
| Rate for Payer: BCBS MAPPO |
$898.75
|
| Rate for Payer: BCBS Trust/PPO |
$74.49
|
| Rate for Payer: BCN Commercial |
$1,329.21
|
| Rate for Payer: BCN Medicare Advantage |
$898.75
|
| Rate for Payer: Cash Price |
$2,174.40
|
| Rate for Payer: Cash Price |
$2,174.40
|
| Rate for Payer: Cofinity Commercial |
$1,204.32
|
| Rate for Payer: Cofinity Commercial |
$1,294.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$898.75
|
| Rate for Payer: Mclaren Medicaid |
$584.26
|
| Rate for Payer: Meridian Medicaid |
$613.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$943.69
|
| Rate for Payer: PACE SWMI |
$898.75
|
| Rate for Payer: PHP Medicare Advantage |
$898.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$584.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,902.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,287.71
|
| Rate for Payer: Priority Health Medicare |
$898.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,287.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$898.75
|
| Rate for Payer: UHC Medicare Advantage |
$925.71
|
|
|
PR LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,446.00
|
|
|
Service Code
|
HCPCS 59150
|
| Min. Negotiated Rate |
$284.23 |
| Max. Negotiated Rate |
$1,167.45 |
| Rate for Payer: Aetna Commercial |
$1,065.35
|
| Rate for Payer: Aetna Medicare |
$826.84
|
| Rate for Payer: BCBS Complete |
$537.21
|
| Rate for Payer: BCBS MAPPO |
$795.04
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCN Commercial |
$1,167.45
|
| Rate for Payer: BCN Medicare Advantage |
$795.04
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,065.35
|
| Rate for Payer: Cofinity Commercial |
$1,144.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$795.04
|
| Rate for Payer: Mclaren Medicaid |
$511.63
|
| Rate for Payer: Meridian Medicaid |
$537.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$834.79
|
| Rate for Payer: PACE SWMI |
$795.04
|
| Rate for Payer: PHP Medicare Advantage |
$795.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$511.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,128.03
|
| Rate for Payer: Priority Health Medicare |
$795.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,128.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$795.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$795.04
|
| Rate for Payer: UHC Medicare Advantage |
$818.89
|
|
|
PR LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 59151
|
| Min. Negotiated Rate |
$447.47 |
| Max. Negotiated Rate |
$1,142.04 |
| Rate for Payer: Aetna Commercial |
$1,042.52
|
| Rate for Payer: Aetna Medicare |
$809.12
|
| Rate for Payer: BCBS Complete |
$525.58
|
| Rate for Payer: BCBS MAPPO |
$778.00
|
| Rate for Payer: BCBS Trust/PPO |
$447.47
|
| Rate for Payer: BCN Commercial |
$1,142.04
|
| Rate for Payer: BCN Medicare Advantage |
$778.00
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$1,120.32
|
| Rate for Payer: Cofinity Commercial |
$1,042.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$778.00
|
| Rate for Payer: Mclaren Medicaid |
$500.55
|
| Rate for Payer: Meridian Medicaid |
$525.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$816.90
|
| Rate for Payer: PACE SWMI |
$778.00
|
| Rate for Payer: PHP Medicare Advantage |
$778.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$954.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,103.46
|
| Rate for Payer: Priority Health Medicare |
$778.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,103.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$778.00
|
| Rate for Payer: UHC Medicare Advantage |
$801.34
|
|
|
PR LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,833.00
|
|
|
Service Code
|
HCPCS 50947
|
| Min. Negotiated Rate |
$875.43 |
| Max. Negotiated Rate |
$5,304.13 |
| Rate for Payer: Aetna Commercial |
$1,808.66
|
| Rate for Payer: Aetna Medicare |
$1,403.74
|
| Rate for Payer: BCBS Complete |
$919.20
|
| Rate for Payer: BCBS MAPPO |
$1,349.75
|
| Rate for Payer: BCBS Trust/PPO |
$5,304.13
|
| Rate for Payer: BCN Commercial |
$1,985.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,349.75
|
| Rate for Payer: Cash Price |
$2,266.40
|
| Rate for Payer: Cash Price |
$2,266.40
|
| Rate for Payer: Cofinity Commercial |
$1,943.64
|
| Rate for Payer: Cofinity Commercial |
$1,808.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,349.75
|
| Rate for Payer: Mclaren Medicaid |
$875.43
|
| Rate for Payer: Meridian Medicaid |
$919.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,417.24
|
| Rate for Payer: PACE SWMI |
$1,349.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,349.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$875.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,983.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,196.02
|
| Rate for Payer: Priority Health Medicare |
$1,349.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,196.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,349.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,349.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,390.24
|
|
|
PR LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,566.00
|
|
|
Service Code
|
HCPCS 50948
|
| Min. Negotiated Rate |
$802.80 |
| Max. Negotiated Rate |
$2,539.54 |
| Rate for Payer: Aetna Commercial |
$1,665.47
|
| Rate for Payer: Aetna Medicare |
$1,292.61
|
| Rate for Payer: BCBS Complete |
$842.94
|
| Rate for Payer: BCBS MAPPO |
$1,242.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.54
|
| Rate for Payer: BCN Commercial |
$1,828.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,242.89
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,789.76
|
| Rate for Payer: Cofinity Commercial |
$1,665.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,242.89
|
| Rate for Payer: Mclaren Medicaid |
$802.80
|
| Rate for Payer: Meridian Medicaid |
$842.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,305.03
|
| Rate for Payer: PACE SWMI |
$1,242.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,242.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$802.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,021.48
|
| Rate for Payer: Priority Health Medicare |
$1,242.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,021.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,242.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,242.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,280.18
|
|
|
PR LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR
|
Professional
|
Both
|
$3,167.00
|
|
|
Service Code
|
HCPCS 58554
|
| Min. Negotiated Rate |
$639.24 |
| Max. Negotiated Rate |
$2,216.90 |
| Rate for Payer: Aetna Commercial |
$1,735.88
|
| Rate for Payer: Aetna Medicare |
$1,347.25
|
| Rate for Payer: BCBS Complete |
$878.05
|
| Rate for Payer: BCBS MAPPO |
$1,295.43
|
| Rate for Payer: BCBS Trust/PPO |
$639.24
|
| Rate for Payer: BCN Commercial |
$1,906.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,295.43
|
| Rate for Payer: Cash Price |
$2,533.60
|
| Rate for Payer: Cash Price |
$2,533.60
|
| Rate for Payer: Cofinity Commercial |
$1,735.88
|
| Rate for Payer: Cofinity Commercial |
$1,865.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,295.43
|
| Rate for Payer: Mclaren Medicaid |
$836.24
|
| Rate for Payer: Meridian Medicaid |
$878.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,360.20
|
| Rate for Payer: PACE SWMI |
$1,295.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,295.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,216.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,847.30
|
| Rate for Payer: Priority Health Medicare |
$1,295.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,847.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,295.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,295.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,334.29
|
|
|
PR LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,468.00
|
|
|
Service Code
|
HCPCS 58550
|
| Min. Negotiated Rate |
$395.17 |
| Max. Negotiated Rate |
$1,727.60 |
| Rate for Payer: Aetna Commercial |
$1,173.77
|
| Rate for Payer: Aetna Medicare |
$910.99
|
| Rate for Payer: BCBS Complete |
$594.91
|
| Rate for Payer: BCBS MAPPO |
$875.95
|
| Rate for Payer: BCBS Trust/PPO |
$395.17
|
| Rate for Payer: BCN Commercial |
$1,292.55
|
| Rate for Payer: BCN Medicare Advantage |
$875.95
|
| Rate for Payer: Cash Price |
$1,974.40
|
| Rate for Payer: Cash Price |
$1,974.40
|
| Rate for Payer: Cofinity Commercial |
$1,173.77
|
| Rate for Payer: Cofinity Commercial |
$1,261.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.95
|
| Rate for Payer: Mclaren Medicaid |
$566.58
|
| Rate for Payer: Meridian Medicaid |
$594.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$919.75
|
| Rate for Payer: PACE SWMI |
$875.95
|
| Rate for Payer: PHP Medicare Advantage |
$875.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,727.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,252.21
|
| Rate for Payer: Priority Health Medicare |
$875.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,252.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$875.95
|
| Rate for Payer: UHC Medicare Advantage |
$902.23
|
|
|
PR LAPS W/REVISION INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$938.00
|
|
|
Service Code
|
HCPCS 49325
|
| Min. Negotiated Rate |
$264.12 |
| Max. Negotiated Rate |
$1,351.92 |
| Rate for Payer: Aetna Commercial |
$550.97
|
| Rate for Payer: Aetna Medicare |
$427.62
|
| Rate for Payer: BCBS Complete |
$277.33
|
| Rate for Payer: BCBS MAPPO |
$411.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,351.92
|
| Rate for Payer: BCN Commercial |
$603.52
|
| Rate for Payer: BCN Medicare Advantage |
$411.17
|
| Rate for Payer: Cash Price |
$750.40
|
| Rate for Payer: Cash Price |
$750.40
|
| Rate for Payer: Cofinity Commercial |
$550.97
|
| Rate for Payer: Cofinity Commercial |
$592.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.17
|
| Rate for Payer: Mclaren Medicaid |
$264.12
|
| Rate for Payer: Meridian Medicaid |
$277.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$431.73
|
| Rate for Payer: PACE SWMI |
$411.17
|
| Rate for Payer: PHP Medicare Advantage |
$411.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$726.15
|
| Rate for Payer: Priority Health Medicare |
$411.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$726.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$411.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.17
|
| Rate for Payer: UHC Medicare Advantage |
$423.51
|
|
|
PR LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES
|
Professional
|
Both
|
$2,460.00
|
|
|
Service Code
|
HCPCS 58552
|
| Min. Negotiated Rate |
$549.43 |
| Max. Negotiated Rate |
$1,722.00 |
| Rate for Payer: Aetna Commercial |
$1,306.27
|
| Rate for Payer: Aetna Medicare |
$1,013.82
|
| Rate for Payer: BCBS Complete |
$660.66
|
| Rate for Payer: BCBS MAPPO |
$974.83
|
| Rate for Payer: BCBS Trust/PPO |
$549.43
|
| Rate for Payer: BCN Commercial |
$1,437.69
|
| Rate for Payer: BCN Medicare Advantage |
$974.83
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cofinity Commercial |
$1,403.76
|
| Rate for Payer: Cofinity Commercial |
$1,306.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.83
|
| Rate for Payer: Mclaren Medicaid |
$629.20
|
| Rate for Payer: Meridian Medicaid |
$660.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,023.57
|
| Rate for Payer: PACE SWMI |
$974.83
|
| Rate for Payer: PHP Medicare Advantage |
$974.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,722.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,392.81
|
| Rate for Payer: Priority Health Medicare |
$974.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,392.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$974.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$974.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,004.07
|
|
|
PR LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS
|
Professional
|
Both
|
$2,957.00
|
|
|
Service Code
|
HCPCS 58553
|
| Min. Negotiated Rate |
$543.62 |
| Max. Negotiated Rate |
$2,069.90 |
| Rate for Payer: Aetna Commercial |
$1,494.17
|
| Rate for Payer: Aetna Medicare |
$1,159.65
|
| Rate for Payer: BCBS Complete |
$753.48
|
| Rate for Payer: BCBS MAPPO |
$1,115.05
|
| Rate for Payer: BCBS Trust/PPO |
$543.62
|
| Rate for Payer: BCN Commercial |
$1,640.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,115.05
|
| Rate for Payer: Cash Price |
$2,365.60
|
| Rate for Payer: Cash Price |
$2,365.60
|
| Rate for Payer: Cofinity Commercial |
$1,494.17
|
| Rate for Payer: Cofinity Commercial |
$1,605.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,115.05
|
| Rate for Payer: Mclaren Medicaid |
$717.60
|
| Rate for Payer: Meridian Medicaid |
$753.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,170.80
|
| Rate for Payer: PACE SWMI |
$1,115.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,115.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$717.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,069.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,588.81
|
| Rate for Payer: Priority Health Medicare |
$1,115.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,588.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,115.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,148.50
|
|
|
PR LAPT RPR PARAESOPH HIATAL HERNIA W/MESH
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 43333
|
| Min. Negotiated Rate |
$801.95 |
| Max. Negotiated Rate |
$2,198.43 |
| Rate for Payer: Aetna Commercial |
$1,672.79
|
| Rate for Payer: Aetna Medicare |
$1,298.28
|
| Rate for Payer: BCBS Complete |
$842.05
|
| Rate for Payer: BCBS MAPPO |
$1,248.35
|
| Rate for Payer: BCBS Trust/PPO |
$856.37
|
| Rate for Payer: BCN Commercial |
$1,827.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,248.35
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cofinity Commercial |
$1,672.79
|
| Rate for Payer: Cofinity Commercial |
$1,797.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,248.35
|
| Rate for Payer: Mclaren Medicaid |
$801.95
|
| Rate for Payer: Meridian Medicaid |
$842.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,310.77
|
| Rate for Payer: PACE SWMI |
$1,248.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,248.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,198.43
|
| Rate for Payer: Priority Health Medicare |
$1,248.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,198.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,248.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,248.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,285.80
|
|
|
PR LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK
|
Professional
|
Both
|
$2,108.00
|
|
|
Service Code
|
HCPCS 58960
|
| Min. Negotiated Rate |
$603.32 |
| Max. Negotiated Rate |
$1,475.60 |
| Rate for Payer: Aetna Commercial |
$1,316.19
|
| Rate for Payer: Aetna Medicare |
$1,021.52
|
| Rate for Payer: BCBS Complete |
$673.64
|
| Rate for Payer: BCBS MAPPO |
$982.23
|
| Rate for Payer: BCBS Trust/PPO |
$603.32
|
| Rate for Payer: BCN Commercial |
$1,456.26
|
| Rate for Payer: BCN Medicare Advantage |
$982.23
|
| Rate for Payer: Cash Price |
$1,686.40
|
| Rate for Payer: Cash Price |
$1,686.40
|
| Rate for Payer: Cofinity Commercial |
$1,316.19
|
| Rate for Payer: Cofinity Commercial |
$1,414.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$982.23
|
| Rate for Payer: Mclaren Medicaid |
$641.56
|
| Rate for Payer: Meridian Medicaid |
$673.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,031.34
|
| Rate for Payer: PACE SWMI |
$982.23
|
| Rate for Payer: PHP Medicare Advantage |
$982.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,475.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,410.81
|
| Rate for Payer: Priority Health Medicare |
$982.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,410.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$982.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$982.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,011.70
|
|
|
PR LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS
|
Professional
|
Both
|
$2,368.00
|
|
|
Service Code
|
HCPCS 47015
|
| Min. Negotiated Rate |
$241.96 |
| Max. Negotiated Rate |
$2,049.09 |
| Rate for Payer: Aetna Commercial |
$1,551.12
|
| Rate for Payer: Aetna Medicare |
$1,203.85
|
| Rate for Payer: BCBS Complete |
$782.55
|
| Rate for Payer: BCBS MAPPO |
$1,157.55
|
| Rate for Payer: BCBS Trust/PPO |
$241.96
|
| Rate for Payer: BCN Commercial |
$1,703.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,157.55
|
| Rate for Payer: Cash Price |
$1,894.40
|
| Rate for Payer: Cash Price |
$1,894.40
|
| Rate for Payer: Cofinity Commercial |
$1,551.12
|
| Rate for Payer: Cofinity Commercial |
$1,666.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,157.55
|
| Rate for Payer: Mclaren Medicaid |
$745.29
|
| Rate for Payer: Meridian Medicaid |
$782.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,215.43
|
| Rate for Payer: PACE SWMI |
$1,157.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,157.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,049.09
|
| Rate for Payer: Priority Health Medicare |
$1,157.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,049.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,157.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,157.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,192.28
|
|
|
PR LAP,W/CHOLANGIOGRAPHY,BIOPSY
|
Professional
|
Both
|
$2,117.00
|
|
|
Service Code
|
HCPCS 47561
|
| Min. Negotiated Rate |
$846.80 |
| Max. Negotiated Rate |
$1,481.90 |
| Rate for Payer: BCBS Complete |
$846.80
|
| Rate for Payer: Cash Price |
$1,693.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,481.90
|
|
|
PR LAP,W/CHOLANGIOGRAPHY,W/O BX
|
Professional
|
Both
|
$477.00
|
|
|
Service Code
|
HCPCS 47560
|
| Min. Negotiated Rate |
$190.80 |
| Max. Negotiated Rate |
$333.90 |
| Rate for Payer: BCBS Complete |
$190.80
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.90
|
|
|
PR LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE
|
Professional
|
Both
|
$777.00
|
|
|
Service Code
|
HCPCS 31561
|
| Min. Negotiated Rate |
$216.20 |
| Max. Negotiated Rate |
$1,441.20 |
| Rate for Payer: Aetna Commercial |
$449.22
|
| Rate for Payer: Aetna Medicare |
$348.65
|
| Rate for Payer: BCBS Complete |
$227.01
|
| Rate for Payer: BCBS MAPPO |
$335.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,441.20
|
| Rate for Payer: BCN Commercial |
$494.54
|
| Rate for Payer: BCN Medicare Advantage |
$335.24
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cofinity Commercial |
$482.75
|
| Rate for Payer: Cofinity Commercial |
$449.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.24
|
| Rate for Payer: Mclaren Medicaid |
$216.20
|
| Rate for Payer: Meridian Medicaid |
$227.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$352.00
|
| Rate for Payer: PACE SWMI |
$335.24
|
| Rate for Payer: PHP Medicare Advantage |
$335.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$468.60
|
| Rate for Payer: Priority Health Medicare |
$335.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$468.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$335.24
|
| Rate for Payer: UHC Medicare Advantage |
$345.30
|
|
|
PR LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP
|
Professional
|
Both
|
$1,186.00
|
|
|
Service Code
|
HCPCS 31541
|
| Min. Negotiated Rate |
$166.78 |
| Max. Negotiated Rate |
$1,146.94 |
| Rate for Payer: Aetna Commercial |
$346.63
|
| Rate for Payer: Aetna Medicare |
$269.03
|
| Rate for Payer: BCBS Complete |
$175.12
|
| Rate for Payer: BCBS MAPPO |
$258.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,146.94
|
| Rate for Payer: BCN Commercial |
$382.15
|
| Rate for Payer: BCN Medicare Advantage |
$258.68
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cofinity Commercial |
$346.63
|
| Rate for Payer: Cofinity Commercial |
$372.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.68
|
| Rate for Payer: Mclaren Medicaid |
$166.78
|
| Rate for Payer: Meridian Medicaid |
$175.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$271.61
|
| Rate for Payer: PACE SWMI |
$258.68
|
| Rate for Payer: PHP Medicare Advantage |
$258.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$830.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$362.10
|
| Rate for Payer: Priority Health Medicare |
$258.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$362.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.68
|
| Rate for Payer: UHC Medicare Advantage |
$266.44
|
|
|
PR LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP
|
Professional
|
Both
|
$1,305.00
|
|
|
Service Code
|
HCPCS 31545
|
| Min. Negotiated Rate |
$229.19 |
| Max. Negotiated Rate |
$1,178.11 |
| Rate for Payer: Aetna Commercial |
$475.66
|
| Rate for Payer: Aetna Medicare |
$369.17
|
| Rate for Payer: BCBS Complete |
$240.65
|
| Rate for Payer: BCBS MAPPO |
$354.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,178.11
|
| Rate for Payer: BCN Commercial |
$523.86
|
| Rate for Payer: BCN Medicare Advantage |
$354.97
|
| Rate for Payer: Cash Price |
$1,044.00
|
| Rate for Payer: Cash Price |
$1,044.00
|
| Rate for Payer: Cofinity Commercial |
$511.16
|
| Rate for Payer: Cofinity Commercial |
$475.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.97
|
| Rate for Payer: Mclaren Medicaid |
$229.19
|
| Rate for Payer: Meridian Medicaid |
$240.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.72
|
| Rate for Payer: PACE SWMI |
$354.97
|
| Rate for Payer: PHP Medicare Advantage |
$354.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.38
|
| Rate for Payer: Priority Health Medicare |
$354.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$496.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.97
|
| Rate for Payer: UHC Medicare Advantage |
$365.62
|
|
|
PR LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Professional
|
Both
|
$1,086.00
|
|
|
Service Code
|
HCPCS 31571
|
| Min. Negotiated Rate |
$157.83 |
| Max. Negotiated Rate |
$760.20 |
| Rate for Payer: Aetna Commercial |
$326.52
|
| Rate for Payer: Aetna Medicare |
$253.42
|
| Rate for Payer: BCBS Complete |
$165.72
|
| Rate for Payer: BCBS MAPPO |
$243.67
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$360.16
|
| Rate for Payer: BCN Medicare Advantage |
$243.67
|
| Rate for Payer: Cash Price |
$868.80
|
| Rate for Payer: Cash Price |
$868.80
|
| Rate for Payer: Cofinity Commercial |
$326.52
|
| Rate for Payer: Cofinity Commercial |
$350.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.67
|
| Rate for Payer: Mclaren Medicaid |
$157.83
|
| Rate for Payer: Meridian Medicaid |
$165.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$255.85
|
| Rate for Payer: PACE SWMI |
$243.67
|
| Rate for Payer: PHP Medicare Advantage |
$243.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.27
|
| Rate for Payer: Priority Health Medicare |
$243.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.67
|
| Rate for Payer: UHC Medicare Advantage |
$250.98
|
|
|
PR LARYNGOPLASTY MEDIALIZATION UNLIATERAL
|
Professional
|
Both
|
$2,163.00
|
|
|
Service Code
|
HCPCS 31591
|
| Min. Negotiated Rate |
$706.95 |
| Max. Negotiated Rate |
$1,621.92 |
| Rate for Payer: Aetna Commercial |
$1,442.32
|
| Rate for Payer: Aetna Medicare |
$1,119.41
|
| Rate for Payer: BCBS Complete |
$742.30
|
| Rate for Payer: BCBS MAPPO |
$1,076.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,000.07
|
| Rate for Payer: BCN Commercial |
$1,621.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,076.36
|
| Rate for Payer: Cash Price |
$1,730.40
|
| Rate for Payer: Cash Price |
$1,730.40
|
| Rate for Payer: Cofinity Commercial |
$1,549.96
|
| Rate for Payer: Cofinity Commercial |
$1,442.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,076.36
|
| Rate for Payer: Mclaren Medicaid |
$706.95
|
| Rate for Payer: Meridian Medicaid |
$742.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,130.18
|
| Rate for Payer: PACE SWMI |
$1,076.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,076.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$706.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,514.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,536.85
|
| Rate for Payer: Priority Health Medicare |
$1,076.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,536.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,076.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,076.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,108.65
|
|
|
PR LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 31570
|
| Min. Negotiated Rate |
$145.48 |
| Max. Negotiated Rate |
$503.83 |
| Rate for Payer: Aetna Commercial |
$301.31
|
| Rate for Payer: Aetna Medicare |
$233.85
|
| Rate for Payer: BCBS Complete |
$152.75
|
| Rate for Payer: BCBS MAPPO |
$224.86
|
| Rate for Payer: BCBS Trust/PPO |
$419.47
|
| Rate for Payer: BCN Commercial |
$503.83
|
| Rate for Payer: BCN Medicare Advantage |
$224.86
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cofinity Commercial |
$323.80
|
| Rate for Payer: Cofinity Commercial |
$301.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.86
|
| Rate for Payer: Mclaren Medicaid |
$145.48
|
| Rate for Payer: Meridian Medicaid |
$152.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$236.10
|
| Rate for Payer: PACE SWMI |
$224.86
|
| Rate for Payer: PHP Medicare Advantage |
$224.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$314.87
|
| Rate for Payer: Priority Health Medicare |
$224.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$314.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$224.86
|
| Rate for Payer: UHC Medicare Advantage |
$231.61
|
|
|
PR LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 31535
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$1,639.31 |
| Rate for Payer: Aetna Commercial |
$247.73
|
| Rate for Payer: Aetna Medicare |
$192.26
|
| Rate for Payer: BCBS Complete |
$126.14
|
| Rate for Payer: BCBS MAPPO |
$184.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,639.31
|
| Rate for Payer: BCN Commercial |
$273.66
|
| Rate for Payer: BCN Medicare Advantage |
$184.87
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$247.73
|
| Rate for Payer: Cofinity Commercial |
$266.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.87
|
| Rate for Payer: Mclaren Medicaid |
$120.13
|
| Rate for Payer: Meridian Medicaid |
$126.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$194.11
|
| Rate for Payer: PACE SWMI |
$184.87
|
| Rate for Payer: PHP Medicare Advantage |
$184.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.31
|
| Rate for Payer: Priority Health Medicare |
$184.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.87
|
| Rate for Payer: UHC Medicare Advantage |
$190.42
|
|
|
PR LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT
|
Professional
|
Both
|
$437.00
|
|
|
Service Code
|
HCPCS 31540
|
| Min. Negotiated Rate |
$152.93 |
| Max. Negotiated Rate |
$1,165.96 |
| Rate for Payer: Aetna Commercial |
$317.67
|
| Rate for Payer: Aetna Medicare |
$246.55
|
| Rate for Payer: BCBS Complete |
$160.58
|
| Rate for Payer: BCBS MAPPO |
$237.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,165.96
|
| Rate for Payer: BCN Commercial |
$350.38
|
| Rate for Payer: BCN Medicare Advantage |
$237.07
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$341.38
|
| Rate for Payer: Cofinity Commercial |
$317.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.07
|
| Rate for Payer: Mclaren Medicaid |
$152.93
|
| Rate for Payer: Meridian Medicaid |
$160.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$248.92
|
| Rate for Payer: PACE SWMI |
$237.07
|
| Rate for Payer: PHP Medicare Advantage |
$237.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.00
|
| Rate for Payer: Priority Health Medicare |
$237.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$332.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.07
|
| Rate for Payer: UHC Medicare Advantage |
$244.18
|
|
|
PR LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI
|
Professional
|
Both
|
$740.00
|
|
|
Service Code
|
HCPCS 31572
|
| Min. Negotiated Rate |
$114.81 |
| Max. Negotiated Rate |
$1,069.81 |
| Rate for Payer: Aetna Commercial |
$237.53
|
| Rate for Payer: Aetna Medicare |
$184.35
|
| Rate for Payer: BCBS Complete |
$120.55
|
| Rate for Payer: BCBS MAPPO |
$177.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.81
|
| Rate for Payer: BCN Commercial |
$777.97
|
| Rate for Payer: BCN Medicare Advantage |
$177.26
|
| Rate for Payer: Cash Price |
$592.00
|
| Rate for Payer: Cash Price |
$592.00
|
| Rate for Payer: Cofinity Commercial |
$255.25
|
| Rate for Payer: Cofinity Commercial |
$237.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.26
|
| Rate for Payer: Mclaren Medicaid |
$114.81
|
| Rate for Payer: Meridian Medicaid |
$120.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.12
|
| Rate for Payer: PACE SWMI |
$177.26
|
| Rate for Payer: PHP Medicare Advantage |
$177.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.65
|
| Rate for Payer: Priority Health Medicare |
$177.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.26
|
| Rate for Payer: UHC Medicare Advantage |
$182.58
|
|
|
PR LARYNGOSCOPY FLEXIBLE DIAGNOSTIC
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 31575
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$1,261.05 |
| Rate for Payer: Aetna Commercial |
$88.83
|
| Rate for Payer: Aetna Medicare |
$68.94
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$66.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,261.05
|
| Rate for Payer: BCN Commercial |
$153.14
|
| Rate for Payer: BCN Medicare Advantage |
$66.29
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cofinity Commercial |
$95.46
|
| Rate for Payer: Cofinity Commercial |
$88.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.29
|
| Rate for Payer: Mclaren Medicaid |
$43.88
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.60
|
| Rate for Payer: PACE SWMI |
$66.29
|
| Rate for Payer: PHP Medicare Advantage |
$66.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.00
|
| Rate for Payer: Priority Health Medicare |
$66.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.29
|
| Rate for Payer: UHC Medicare Advantage |
$68.28
|
|
