|
PR CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE
|
Professional
|
Both
|
$2,521.00
|
|
|
Service Code
|
HCPCS 51860
|
| Min. Negotiated Rate |
$434.95 |
| Max. Negotiated Rate |
$1,890.75 |
| Rate for Payer: Aetna Commercial |
$958.23
|
| Rate for Payer: Aetna Medicare |
$1,260.50
|
| Rate for Payer: BCBS Complete |
$456.70
|
| Rate for Payer: BCN Commercial |
$1,114.98
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Mclaren Medicaid |
$434.95
|
| Rate for Payer: Meridian Medicaid |
$456.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,890.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,214.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,214.58
|
| Rate for Payer: UHC Medicaid |
$434.95
|
| Rate for Payer: UHCCP Medicaid |
$434.95
|
|
|
PR CYSTOSTOMY CYSTOTOMY W/DRAINAGE
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 51040
|
| Min. Negotiated Rate |
$174.02 |
| Max. Negotiated Rate |
$480.62 |
| Rate for Payer: Aetna Commercial |
$370.57
|
| Rate for Payer: Aetna Medicare |
$281.00
|
| Rate for Payer: BCBS Complete |
$182.72
|
| Rate for Payer: BCN Commercial |
$441.21
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Mclaren Medicaid |
$174.02
|
| Rate for Payer: Meridian Medicaid |
$182.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$480.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.62
|
| Rate for Payer: UHC Medicaid |
$174.02
|
| Rate for Payer: UHCCP Medicaid |
$174.02
|
|
|
PR CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL
|
Professional
|
Both
|
$2,524.00
|
|
|
Service Code
|
HCPCS 51020
|
| Min. Negotiated Rate |
$277.75 |
| Max. Negotiated Rate |
$1,893.00 |
| Rate for Payer: Aetna Commercial |
$601.20
|
| Rate for Payer: Aetna Medicare |
$1,262.00
|
| Rate for Payer: BCBS Complete |
$291.64
|
| Rate for Payer: BCN Commercial |
$708.63
|
| Rate for Payer: Cash Price |
$2,019.20
|
| Rate for Payer: Cash Price |
$2,019.20
|
| Rate for Payer: Mclaren Medicaid |
$277.75
|
| Rate for Payer: Meridian Medicaid |
$291.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,893.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$771.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$771.92
|
| Rate for Payer: UHC Medicaid |
$277.75
|
| Rate for Payer: UHCCP Medicaid |
$277.75
|
|
|
PR CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE
|
Professional
|
Both
|
$2,062.00
|
|
|
Service Code
|
HCPCS 51525
|
| Min. Negotiated Rate |
$493.10 |
| Max. Negotiated Rate |
$1,546.50 |
| Rate for Payer: Aetna Commercial |
$1,103.89
|
| Rate for Payer: Aetna Medicare |
$1,031.00
|
| Rate for Payer: BCBS Complete |
$517.75
|
| Rate for Payer: BCN Commercial |
$1,282.31
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Mclaren Medicaid |
$493.10
|
| Rate for Payer: Meridian Medicaid |
$517.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,546.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,396.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,396.84
|
| Rate for Payer: UHC Medicaid |
$493.10
|
| Rate for Payer: UHCCP Medicaid |
$493.10
|
|
|
PR CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE
|
Professional
|
Both
|
$1,781.00
|
|
|
Service Code
|
HCPCS 51535
|
| Min. Negotiated Rate |
$449.22 |
| Max. Negotiated Rate |
$1,335.75 |
| Rate for Payer: Aetna Commercial |
$1,001.20
|
| Rate for Payer: Aetna Medicare |
$890.50
|
| Rate for Payer: BCBS Complete |
$471.68
|
| Rate for Payer: BCN Commercial |
$1,167.77
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Mclaren Medicaid |
$449.22
|
| Rate for Payer: Meridian Medicaid |
$471.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,335.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,272.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,272.08
|
| Rate for Payer: UHC Medicaid |
$449.22
|
| Rate for Payer: UHCCP Medicaid |
$449.22
|
|
|
PR CYSTOTOMY EXCISION BLADDER TUMOR
|
Professional
|
Both
|
$1,432.00
|
|
|
Service Code
|
HCPCS 51530
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$1,255.80 |
| Rate for Payer: Aetna Commercial |
$988.36
|
| Rate for Payer: Aetna Medicare |
$716.00
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCN Commercial |
$1,152.83
|
| Rate for Payer: Cash Price |
$1,145.60
|
| Rate for Payer: Cash Price |
$1,145.60
|
| Rate for Payer: Mclaren Medicaid |
$444.11
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,074.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,255.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,255.80
|
| Rate for Payer: UHC Medicaid |
$444.11
|
| Rate for Payer: UHCCP Medicaid |
$444.11
|
|
|
PR CYSTOTOMY SIMPLE EXCISION VESICAL NECK
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 51520
|
| Min. Negotiated Rate |
$347.19 |
| Max. Negotiated Rate |
$975.89 |
| Rate for Payer: Aetna Commercial |
$763.07
|
| Rate for Payer: Aetna Medicare |
$632.50
|
| Rate for Payer: BCBS Complete |
$364.55
|
| Rate for Payer: BCN Commercial |
$895.87
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Mclaren Medicaid |
$347.19
|
| Rate for Payer: Meridian Medicaid |
$364.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$975.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$975.89
|
| Rate for Payer: UHC Medicaid |
$347.19
|
| Rate for Payer: UHCCP Medicaid |
$347.19
|
|
|
PR CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO
|
Professional
|
Both
|
$2,028.00
|
|
|
Service Code
|
HCPCS 51065
|
| Min. Negotiated Rate |
$338.03 |
| Max. Negotiated Rate |
$1,521.00 |
| Rate for Payer: Aetna Commercial |
$743.33
|
| Rate for Payer: Aetna Medicare |
$1,014.00
|
| Rate for Payer: BCBS Complete |
$354.93
|
| Rate for Payer: BCN Commercial |
$872.96
|
| Rate for Payer: Cash Price |
$1,622.40
|
| Rate for Payer: Cash Price |
$1,622.40
|
| Rate for Payer: Mclaren Medicaid |
$338.03
|
| Rate for Payer: Meridian Medicaid |
$354.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,521.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$950.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$950.93
|
| Rate for Payer: UHC Medicaid |
$338.03
|
| Rate for Payer: UHCCP Medicaid |
$338.03
|
|
|
PR CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX
|
Professional
|
Both
|
$1,063.00
|
|
|
Service Code
|
HCPCS 51045
|
| Min. Negotiated Rate |
$291.17 |
| Max. Negotiated Rate |
$806.10 |
| Rate for Payer: Aetna Commercial |
$645.19
|
| Rate for Payer: Aetna Medicare |
$531.50
|
| Rate for Payer: BCBS Complete |
$305.73
|
| Rate for Payer: BCN Commercial |
$740.00
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Mclaren Medicaid |
$291.17
|
| Rate for Payer: Meridian Medicaid |
$305.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$797.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$806.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.10
|
| Rate for Payer: UHC Medicaid |
$291.17
|
| Rate for Payer: UHCCP Medicaid |
$291.17
|
|
|
PR CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 52356
|
| Min. Negotiated Rate |
$232.81 |
| Max. Negotiated Rate |
$668.32 |
| Rate for Payer: Aetna Commercial |
$532.71
|
| Rate for Payer: Aetna Medicare |
$436.50
|
| Rate for Payer: BCBS Complete |
$244.45
|
| Rate for Payer: BCN Commercial |
$613.51
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Mclaren Medicaid |
$232.81
|
| Rate for Payer: Meridian Medicaid |
$244.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$654.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$668.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$668.32
|
| Rate for Payer: UHC Medicaid |
$232.81
|
| Rate for Payer: UHCCP Medicaid |
$232.81
|
|
|
PR CYSTOURETHROSCOPY
|
Professional
|
Both
|
$484.00
|
|
|
Service Code
|
HCPCS 52000
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$363.00 |
| Rate for Payer: Aetna Commercial |
$102.99
|
| Rate for Payer: Aetna Medicare |
$242.00
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCN Commercial |
$119.02
|
| Rate for Payer: Cash Price |
$387.20
|
| Rate for Payer: Cash Price |
$387.20
|
| Rate for Payer: Mclaren Medicaid |
$45.37
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$363.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$129.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.65
|
| Rate for Payer: UHC Medicaid |
$45.37
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
|
PR CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 52287
|
| Min. Negotiated Rate |
$95.00 |
| Max. Negotiated Rate |
$544.50 |
| Rate for Payer: Aetna Commercial |
$217.02
|
| Rate for Payer: Aetna Medicare |
$363.00
|
| Rate for Payer: BCBS Complete |
$99.75
|
| Rate for Payer: BCN Commercial |
$250.98
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Mclaren Medicaid |
$95.00
|
| Rate for Payer: Meridian Medicaid |
$99.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$544.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$273.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.41
|
| Rate for Payer: UHC Medicaid |
$95.00
|
| Rate for Payer: UHCCP Medicaid |
$95.00
|
|
|
PR CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 52282
|
| Min. Negotiated Rate |
$189.36 |
| Max. Negotiated Rate |
$542.47 |
| Rate for Payer: Aetna Commercial |
$429.33
|
| Rate for Payer: Aetna Medicare |
$335.00
|
| Rate for Payer: BCBS Complete |
$198.83
|
| Rate for Payer: BCN Commercial |
$497.98
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Mclaren Medicaid |
$189.36
|
| Rate for Payer: Meridian Medicaid |
$198.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$502.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$542.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$542.47
|
| Rate for Payer: UHC Medicaid |
$189.36
|
| Rate for Payer: UHCCP Medicaid |
$189.36
|
|
|
PR CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 52250
|
| Min. Negotiated Rate |
$135.04 |
| Max. Negotiated Rate |
$386.25 |
| Rate for Payer: Aetna Commercial |
$305.69
|
| Rate for Payer: Aetna Medicare |
$257.50
|
| Rate for Payer: BCBS Complete |
$141.79
|
| Rate for Payer: BCN Commercial |
$354.07
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Mclaren Medicaid |
$135.04
|
| Rate for Payer: Meridian Medicaid |
$141.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$386.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$385.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.69
|
| Rate for Payer: UHC Medicaid |
$135.04
|
| Rate for Payer: UHCCP Medicaid |
$135.04
|
|
|
PR CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 52285
|
| Min. Negotiated Rate |
$110.55 |
| Max. Negotiated Rate |
$493.50 |
| Rate for Payer: Aetna Commercial |
$250.61
|
| Rate for Payer: Aetna Medicare |
$329.00
|
| Rate for Payer: BCBS Complete |
$116.08
|
| Rate for Payer: BCN Commercial |
$292.32
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Mclaren Medicaid |
$110.55
|
| Rate for Payer: Meridian Medicaid |
$116.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$493.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.42
|
| Rate for Payer: UHC Medicaid |
$110.55
|
| Rate for Payer: UHCCP Medicaid |
$110.55
|
|
|
PR CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM
|
Professional
|
Both
|
$1,202.00
|
|
|
Service Code
|
HCPCS 52235
|
| Min. Negotiated Rate |
$162.31 |
| Max. Negotiated Rate |
$901.50 |
| Rate for Payer: Aetna Commercial |
$368.99
|
| Rate for Payer: Aetna Medicare |
$601.00
|
| Rate for Payer: BCBS Complete |
$170.43
|
| Rate for Payer: BCN Commercial |
$425.77
|
| Rate for Payer: Cash Price |
$961.60
|
| Rate for Payer: Cash Price |
$961.60
|
| Rate for Payer: Mclaren Medicaid |
$162.31
|
| Rate for Payer: Meridian Medicaid |
$170.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$901.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$463.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$463.80
|
| Rate for Payer: UHC Medicaid |
$162.31
|
| Rate for Payer: UHCCP Medicaid |
$162.31
|
|
|
PR CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE
|
Professional
|
Both
|
$2,310.00
|
|
|
Service Code
|
HCPCS 52240
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Aetna Commercial |
$501.54
|
| Rate for Payer: Aetna Medicare |
$1,155.00
|
| Rate for Payer: BCBS Complete |
$230.58
|
| Rate for Payer: BCN Commercial |
$577.66
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Mclaren Medicaid |
$219.60
|
| Rate for Payer: Meridian Medicaid |
$230.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,732.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$629.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$629.26
|
| Rate for Payer: UHC Medicaid |
$219.60
|
| Rate for Payer: UHCCP Medicaid |
$219.60
|
|
|
PR CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 52260
|
| Min. Negotiated Rate |
$118.43 |
| Max. Negotiated Rate |
$430.67 |
| Rate for Payer: Aetna Commercial |
$269.31
|
| Rate for Payer: Aetna Medicare |
$203.50
|
| Rate for Payer: BCBS Complete |
$124.35
|
| Rate for Payer: BCN Commercial |
$430.67
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Mclaren Medicaid |
$118.43
|
| Rate for Payer: Meridian Medicaid |
$124.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$305.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$339.58
|
| Rate for Payer: UHC Medicaid |
$118.43
|
| Rate for Payer: UHCCP Medicaid |
$118.43
|
|
|
PR CYSTOURETHROSCOPY W/DIL BLADDER LOCAL ANESTHESIA
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 52265
|
| Min. Negotiated Rate |
$92.02 |
| Max. Negotiated Rate |
$492.75 |
| Rate for Payer: Aetna Commercial |
$208.09
|
| Rate for Payer: Aetna Medicare |
$328.50
|
| Rate for Payer: BCBS Complete |
$96.62
|
| Rate for Payer: BCN Commercial |
$241.02
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Mclaren Medicaid |
$92.02
|
| Rate for Payer: Meridian Medicaid |
$96.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$492.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$262.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.56
|
| Rate for Payer: UHC Medicaid |
$92.02
|
| Rate for Payer: UHCCP Medicaid |
$92.02
|
|
|
PR CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 52276
|
| Min. Negotiated Rate |
$148.89 |
| Max. Negotiated Rate |
$866.25 |
| Rate for Payer: Aetna Commercial |
$338.51
|
| Rate for Payer: Aetna Medicare |
$577.50
|
| Rate for Payer: BCBS Complete |
$156.33
|
| Rate for Payer: BCN Commercial |
$390.91
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Mclaren Medicaid |
$148.89
|
| Rate for Payer: Meridian Medicaid |
$156.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$866.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$425.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.83
|
| Rate for Payer: UHC Medicaid |
$148.89
|
| Rate for Payer: UHCCP Medicaid |
$148.89
|
|
|
PR CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY FEMALE
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 52270
|
| Min. Negotiated Rate |
$103.31 |
| Max. Negotiated Rate |
$552.75 |
| Rate for Payer: Aetna Commercial |
$233.02
|
| Rate for Payer: Aetna Medicare |
$368.50
|
| Rate for Payer: BCBS Complete |
$108.48
|
| Rate for Payer: BCN Commercial |
$269.91
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Mclaren Medicaid |
$103.31
|
| Rate for Payer: Meridian Medicaid |
$108.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$294.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.02
|
| Rate for Payer: UHC Medicaid |
$103.31
|
| Rate for Payer: UHCCP Medicaid |
$103.31
|
|
|
PR CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE
|
Professional
|
Both
|
$1,006.00
|
|
|
Service Code
|
HCPCS 52275
|
| Min. Negotiated Rate |
$139.73 |
| Max. Negotiated Rate |
$754.50 |
| Rate for Payer: Aetna Commercial |
$317.31
|
| Rate for Payer: Aetna Medicare |
$503.00
|
| Rate for Payer: BCBS Complete |
$146.72
|
| Rate for Payer: BCN Commercial |
$368.01
|
| Rate for Payer: Cash Price |
$804.80
|
| Rate for Payer: Cash Price |
$804.80
|
| Rate for Payer: Mclaren Medicaid |
$139.73
|
| Rate for Payer: Meridian Medicaid |
$146.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$754.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$400.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$400.88
|
| Rate for Payer: UHC Medicaid |
$139.73
|
| Rate for Payer: UHCCP Medicaid |
$139.73
|
|
|
PR CYSTOURETHROSCOPY WITH BIOPSY
|
Professional
|
Both
|
$770.00
|
|
|
Service Code
|
HCPCS 52204
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$577.50 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna Medicare |
$385.00
|
| Rate for Payer: BCBS Complete |
$84.99
|
| Rate for Payer: BCN Commercial |
$209.65
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Mclaren Medicaid |
$80.94
|
| Rate for Payer: Meridian Medicaid |
$84.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$577.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.38
|
| Rate for Payer: UHC Medicaid |
$80.94
|
| Rate for Payer: UHCCP Medicaid |
$80.94
|
|
|
PR CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS
|
Professional
|
Both
|
$1,469.00
|
|
|
Service Code
|
HCPCS 52320
|
| Min. Negotiated Rate |
$138.02 |
| Max. Negotiated Rate |
$1,101.75 |
| Rate for Payer: Aetna Commercial |
$315.24
|
| Rate for Payer: Aetna Medicare |
$734.50
|
| Rate for Payer: BCBS Complete |
$144.92
|
| Rate for Payer: BCN Commercial |
$364.52
|
| Rate for Payer: Cash Price |
$1,175.20
|
| Rate for Payer: Cash Price |
$1,175.20
|
| Rate for Payer: Mclaren Medicaid |
$138.02
|
| Rate for Payer: Meridian Medicaid |
$144.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,101.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$397.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$397.09
|
| Rate for Payer: UHC Medicaid |
$138.02
|
| Rate for Payer: UHCCP Medicaid |
$138.02
|
|
|
PR CYSTOURETHROSCOPY W/STEROID INJECTION STRICTURE
|
Professional
|
Both
|
$428.00
|
|
|
Service Code
|
HCPCS 52283
|
| Min. Negotiated Rate |
$113.96 |
| Max. Negotiated Rate |
$326.57 |
| Rate for Payer: Aetna Commercial |
$258.19
|
| Rate for Payer: Aetna Medicare |
$214.00
|
| Rate for Payer: BCBS Complete |
$119.66
|
| Rate for Payer: BCN Commercial |
$299.79
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Mclaren Medicaid |
$113.96
|
| Rate for Payer: Meridian Medicaid |
$119.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$321.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$326.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.57
|
| Rate for Payer: UHC Medicaid |
$113.96
|
| Rate for Payer: UHCCP Medicaid |
$113.96
|
|
