|
PR CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM
|
Professional
|
Both
|
$8,727.00
|
|
|
Service Code
|
HCPCS 61520
|
| Min. Negotiated Rate |
$3,490.80 |
| Max. Negotiated Rate |
$5,672.55 |
| Rate for Payer: Aetna Commercial |
$4,923.56
|
| Rate for Payer: Aetna Medicare |
$3,821.27
|
| Rate for Payer: BCBS Complete |
$3,490.80
|
| Rate for Payer: BCBS MAPPO |
$3,674.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,674.30
|
| Rate for Payer: Cash Price |
$6,981.60
|
| Rate for Payer: Cash Price |
$6,981.60
|
| Rate for Payer: Cofinity Commercial |
$5,290.99
|
| Rate for Payer: Cofinity Commercial |
$4,923.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,674.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,858.01
|
| Rate for Payer: Nomi Health Commercial |
$4,409.16
|
| Rate for Payer: PACE SWMI |
$3,674.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,674.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,672.55
|
| Rate for Payer: Priority Health Medicare |
$3,711.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,674.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,674.30
|
| Rate for Payer: UHC Exchange |
$3,674.30
|
| Rate for Payer: UHC Medicare Advantage |
$3,674.30
|
|
|
PR CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF
|
Professional
|
Both
|
$2,767.00
|
|
|
Service Code
|
HCPCS 36825
|
| Min. Negotiated Rate |
$757.26 |
| Max. Negotiated Rate |
$1,798.55 |
| Rate for Payer: Aetna Commercial |
$1,014.73
|
| Rate for Payer: Aetna Medicare |
$787.55
|
| Rate for Payer: BCBS Complete |
$1,106.80
|
| Rate for Payer: BCBS MAPPO |
$757.26
|
| Rate for Payer: BCN Medicare Advantage |
$757.26
|
| Rate for Payer: Cash Price |
$2,213.60
|
| Rate for Payer: Cash Price |
$2,213.60
|
| Rate for Payer: Cofinity Commercial |
$1,090.45
|
| Rate for Payer: Cofinity Commercial |
$1,014.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$757.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$795.12
|
| Rate for Payer: Nomi Health Commercial |
$908.71
|
| Rate for Payer: PACE SWMI |
$757.26
|
| Rate for Payer: PHP Medicare Advantage |
$757.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,798.55
|
| Rate for Payer: Priority Health Medicare |
$764.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$757.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$757.26
|
| Rate for Payer: UHC Exchange |
$757.26
|
| Rate for Payer: UHC Medicare Advantage |
$757.26
|
|
|
PR CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF
|
Professional
|
Both
|
$1,380.00
|
|
|
Service Code
|
HCPCS 36830
|
| Min. Negotiated Rate |
$552.00 |
| Max. Negotiated Rate |
$919.08 |
| Rate for Payer: Aetna Commercial |
$855.25
|
| Rate for Payer: Aetna Medicare |
$663.78
|
| Rate for Payer: BCBS Complete |
$552.00
|
| Rate for Payer: BCBS MAPPO |
$638.25
|
| Rate for Payer: BCN Medicare Advantage |
$638.25
|
| Rate for Payer: Cash Price |
$1,104.00
|
| Rate for Payer: Cash Price |
$1,104.00
|
| Rate for Payer: Cofinity Commercial |
$919.08
|
| Rate for Payer: Cofinity Commercial |
$855.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$638.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$670.16
|
| Rate for Payer: Nomi Health Commercial |
$765.90
|
| Rate for Payer: PACE SWMI |
$638.25
|
| Rate for Payer: PHP Medicare Advantage |
$638.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.00
|
| Rate for Payer: Priority Health Medicare |
$644.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$638.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$638.25
|
| Rate for Payer: UHC Exchange |
$638.25
|
| Rate for Payer: UHC Medicare Advantage |
$638.25
|
|
|
PR CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 35686
|
| Min. Negotiated Rate |
$136.80 |
| Max. Negotiated Rate |
$223.29 |
| Rate for Payer: Aetna Commercial |
$207.78
|
| Rate for Payer: Aetna Medicare |
$161.26
|
| Rate for Payer: BCBS Complete |
$136.80
|
| Rate for Payer: BCBS MAPPO |
$155.06
|
| Rate for Payer: BCN Medicare Advantage |
$155.06
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$223.29
|
| Rate for Payer: Cofinity Commercial |
$207.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.81
|
| Rate for Payer: Nomi Health Commercial |
$186.07
|
| Rate for Payer: PACE SWMI |
$155.06
|
| Rate for Payer: PHP Medicare Advantage |
$155.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.30
|
| Rate for Payer: Priority Health Medicare |
$156.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.06
|
| Rate for Payer: UHC Exchange |
$155.06
|
| Rate for Payer: UHC Medicare Advantage |
$155.06
|
|
|
PR CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX
|
Professional
|
Both
|
$2,550.00
|
|
|
Service Code
|
HCPCS 33025
|
| Min. Negotiated Rate |
$740.30 |
| Max. Negotiated Rate |
$1,657.50 |
| Rate for Payer: Aetna Commercial |
$992.00
|
| Rate for Payer: Aetna Medicare |
$769.91
|
| Rate for Payer: BCBS Complete |
$1,020.00
|
| Rate for Payer: BCBS MAPPO |
$740.30
|
| Rate for Payer: BCN Medicare Advantage |
$740.30
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Commercial |
$992.00
|
| Rate for Payer: Cofinity Commercial |
$1,066.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.32
|
| Rate for Payer: Nomi Health Commercial |
$888.36
|
| Rate for Payer: PACE SWMI |
$740.30
|
| Rate for Payer: PHP Medicare Advantage |
$740.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.50
|
| Rate for Payer: Priority Health Medicare |
$747.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.30
|
| Rate for Payer: UHC Exchange |
$740.30
|
| Rate for Payer: UHC Medicare Advantage |
$740.30
|
|
|
PR CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM
|
Professional
|
Both
|
$4,365.00
|
|
|
Service Code
|
HCPCS 63740
|
| Min. Negotiated Rate |
$977.63 |
| Max. Negotiated Rate |
$2,837.25 |
| Rate for Payer: Aetna Commercial |
$1,310.02
|
| Rate for Payer: Aetna Medicare |
$1,016.74
|
| Rate for Payer: BCBS Complete |
$1,746.00
|
| Rate for Payer: BCBS MAPPO |
$977.63
|
| Rate for Payer: BCN Medicare Advantage |
$977.63
|
| Rate for Payer: Cash Price |
$3,492.00
|
| Rate for Payer: Cash Price |
$3,492.00
|
| Rate for Payer: Cofinity Commercial |
$1,407.79
|
| Rate for Payer: Cofinity Commercial |
$1,310.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$977.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,026.51
|
| Rate for Payer: Nomi Health Commercial |
$1,173.16
|
| Rate for Payer: PACE SWMI |
$977.63
|
| Rate for Payer: PHP Medicare Advantage |
$977.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,837.25
|
| Rate for Payer: Priority Health Medicare |
$987.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$977.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$977.63
|
| Rate for Payer: UHC Exchange |
$977.63
|
| Rate for Payer: UHC Medicare Advantage |
$977.63
|
|
|
PR CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM
|
Professional
|
Both
|
$2,403.00
|
|
|
Service Code
|
HCPCS 63741
|
| Min. Negotiated Rate |
$661.54 |
| Max. Negotiated Rate |
$1,561.95 |
| Rate for Payer: Aetna Commercial |
$886.46
|
| Rate for Payer: Aetna Medicare |
$688.00
|
| Rate for Payer: BCBS Complete |
$961.20
|
| Rate for Payer: BCBS MAPPO |
$661.54
|
| Rate for Payer: BCN Medicare Advantage |
$661.54
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cofinity Commercial |
$952.62
|
| Rate for Payer: Cofinity Commercial |
$886.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$694.62
|
| Rate for Payer: Nomi Health Commercial |
$793.85
|
| Rate for Payer: PACE SWMI |
$661.54
|
| Rate for Payer: PHP Medicare Advantage |
$661.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,561.95
|
| Rate for Payer: Priority Health Medicare |
$668.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$661.54
|
| Rate for Payer: UHC Exchange |
$661.54
|
| Rate for Payer: UHC Medicare Advantage |
$661.54
|
|
|
PR CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH
|
Professional
|
Both
|
$5,855.00
|
|
|
Service Code
|
HCPCS 62192
|
| Min. Negotiated Rate |
$983.17 |
| Max. Negotiated Rate |
$3,805.75 |
| Rate for Payer: Aetna Commercial |
$1,317.45
|
| Rate for Payer: Aetna Medicare |
$1,022.50
|
| Rate for Payer: BCBS Complete |
$2,342.00
|
| Rate for Payer: BCBS MAPPO |
$983.17
|
| Rate for Payer: BCN Medicare Advantage |
$983.17
|
| Rate for Payer: Cash Price |
$4,684.00
|
| Rate for Payer: Cash Price |
$4,684.00
|
| Rate for Payer: Cofinity Commercial |
$1,415.76
|
| Rate for Payer: Cofinity Commercial |
$1,317.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$983.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,032.33
|
| Rate for Payer: Nomi Health Commercial |
$1,179.80
|
| Rate for Payer: PACE SWMI |
$983.17
|
| Rate for Payer: PHP Medicare Advantage |
$983.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,805.75
|
| Rate for Payer: Priority Health Medicare |
$993.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$983.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$983.17
|
| Rate for Payer: UHC Exchange |
$983.17
|
| Rate for Payer: UHC Medicare Advantage |
$983.17
|
|
|
PR CRTJ SHUNT VENTRICULO-ATR-JUG-AUR
|
Professional
|
Both
|
$5,065.00
|
|
|
Service Code
|
HCPCS 62220
|
| Min. Negotiated Rate |
$964.10 |
| Max. Negotiated Rate |
$3,292.25 |
| Rate for Payer: Aetna Commercial |
$1,291.89
|
| Rate for Payer: Aetna Medicare |
$1,002.66
|
| Rate for Payer: BCBS Complete |
$2,026.00
|
| Rate for Payer: BCBS MAPPO |
$964.10
|
| Rate for Payer: BCN Medicare Advantage |
$964.10
|
| Rate for Payer: Cash Price |
$4,052.00
|
| Rate for Payer: Cash Price |
$4,052.00
|
| Rate for Payer: Cofinity Commercial |
$1,388.30
|
| Rate for Payer: Cofinity Commercial |
$1,291.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$964.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,012.30
|
| Rate for Payer: Nomi Health Commercial |
$1,156.92
|
| Rate for Payer: PACE SWMI |
$964.10
|
| Rate for Payer: PHP Medicare Advantage |
$964.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,292.25
|
| Rate for Payer: Priority Health Medicare |
$973.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$964.10
|
| Rate for Payer: UHC Exchange |
$964.10
|
| Rate for Payer: UHC Medicare Advantage |
$964.10
|
|
|
PR CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS
|
Professional
|
Both
|
$5,051.00
|
|
|
Service Code
|
HCPCS 62223
|
| Min. Negotiated Rate |
$1,014.64 |
| Max. Negotiated Rate |
$3,283.15 |
| Rate for Payer: Aetna Commercial |
$1,359.62
|
| Rate for Payer: Aetna Medicare |
$1,055.23
|
| Rate for Payer: BCBS Complete |
$2,020.40
|
| Rate for Payer: BCBS MAPPO |
$1,014.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,014.64
|
| Rate for Payer: Cash Price |
$4,040.80
|
| Rate for Payer: Cash Price |
$4,040.80
|
| Rate for Payer: Cofinity Commercial |
$1,461.08
|
| Rate for Payer: Cofinity Commercial |
$1,359.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,014.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,065.37
|
| Rate for Payer: Nomi Health Commercial |
$1,217.57
|
| Rate for Payer: PACE SWMI |
$1,014.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,014.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,283.15
|
| Rate for Payer: Priority Health Medicare |
$1,024.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,014.64
|
| Rate for Payer: UHC Exchange |
$1,014.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,014.64
|
|
|
PR CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA
|
Professional
|
Both
|
$7,247.00
|
|
|
Service Code
|
HCPCS 62100
|
| Min. Negotiated Rate |
$1,544.50 |
| Max. Negotiated Rate |
$4,710.55 |
| Rate for Payer: Aetna Commercial |
$2,069.63
|
| Rate for Payer: Aetna Medicare |
$1,606.28
|
| Rate for Payer: BCBS Complete |
$2,898.80
|
| Rate for Payer: BCBS MAPPO |
$1,544.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,544.50
|
| Rate for Payer: Cash Price |
$5,797.60
|
| Rate for Payer: Cash Price |
$5,797.60
|
| Rate for Payer: Cofinity Commercial |
$2,224.08
|
| Rate for Payer: Cofinity Commercial |
$2,069.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,544.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,621.72
|
| Rate for Payer: Nomi Health Commercial |
$1,853.40
|
| Rate for Payer: PACE SWMI |
$1,544.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,544.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,710.55
|
| Rate for Payer: Priority Health Medicare |
$1,559.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,544.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,544.50
|
| Rate for Payer: UHC Exchange |
$1,544.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,544.50
|
|
|
PR CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI
|
Professional
|
Both
|
$2,068.00
|
|
|
Service Code
|
HCPCS 55873
|
| Min. Negotiated Rate |
$731.10 |
| Max. Negotiated Rate |
$1,344.20 |
| Rate for Payer: Aetna Commercial |
$979.67
|
| Rate for Payer: Aetna Medicare |
$760.34
|
| Rate for Payer: BCBS Complete |
$827.20
|
| Rate for Payer: BCBS MAPPO |
$731.10
|
| Rate for Payer: BCN Medicare Advantage |
$731.10
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cofinity Commercial |
$979.67
|
| Rate for Payer: Cofinity Commercial |
$1,052.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.65
|
| Rate for Payer: Nomi Health Commercial |
$877.32
|
| Rate for Payer: PACE SWMI |
$731.10
|
| Rate for Payer: PHP Medicare Advantage |
$731.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.20
|
| Rate for Payer: Priority Health Medicare |
$738.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.10
|
| Rate for Payer: UHC Exchange |
$731.10
|
| Rate for Payer: UHC Medicare Advantage |
$731.10
|
|
|
PR CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 17340
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$66.97 |
| Rate for Payer: Aetna Commercial |
$62.32
|
| Rate for Payer: Aetna Medicare |
$48.37
|
| Rate for Payer: BCBS Complete |
$41.20
|
| Rate for Payer: BCBS MAPPO |
$46.51
|
| Rate for Payer: BCN Medicare Advantage |
$46.51
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.84
|
| Rate for Payer: Nomi Health Commercial |
$55.81
|
| Rate for Payer: PACE SWMI |
$46.51
|
| Rate for Payer: PHP Medicare Advantage |
$46.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health Medicare |
$46.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.51
|
| Rate for Payer: UHC Exchange |
$46.51
|
| Rate for Payer: UHC Medicare Advantage |
$46.51
|
|
|
PR CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC
|
Professional
|
Both
|
$4,560.00
|
|
|
Service Code
|
HCPCS 51595
|
| Min. Negotiated Rate |
$1,824.00 |
| Max. Negotiated Rate |
$2,996.91 |
| Rate for Payer: Aetna Commercial |
$2,788.79
|
| Rate for Payer: Aetna Medicare |
$2,164.44
|
| Rate for Payer: BCBS Complete |
$1,824.00
|
| Rate for Payer: BCBS MAPPO |
$2,081.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,081.19
|
| Rate for Payer: Cash Price |
$3,648.00
|
| Rate for Payer: Cash Price |
$3,648.00
|
| Rate for Payer: Cofinity Commercial |
$2,996.91
|
| Rate for Payer: Cofinity Commercial |
$2,788.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,081.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,185.25
|
| Rate for Payer: Nomi Health Commercial |
$2,497.43
|
| Rate for Payer: PACE SWMI |
$2,081.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,081.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,964.00
|
| Rate for Payer: Priority Health Medicare |
$2,102.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,081.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,081.19
|
| Rate for Payer: UHC Exchange |
$2,081.19
|
| Rate for Payer: UHC Medicare Advantage |
$2,081.19
|
|
|
PR CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR
|
Professional
|
Both
|
$4,906.00
|
|
|
Service Code
|
HCPCS 51596
|
| Min. Negotiated Rate |
$1,962.40 |
| Max. Negotiated Rate |
$3,237.38 |
| Rate for Payer: Aetna Commercial |
$3,012.56
|
| Rate for Payer: Aetna Medicare |
$2,338.11
|
| Rate for Payer: BCBS Complete |
$1,962.40
|
| Rate for Payer: BCBS MAPPO |
$2,248.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,248.18
|
| Rate for Payer: Cash Price |
$3,924.80
|
| Rate for Payer: Cash Price |
$3,924.80
|
| Rate for Payer: Cofinity Commercial |
$3,237.38
|
| Rate for Payer: Cofinity Commercial |
$3,012.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,248.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,360.59
|
| Rate for Payer: Nomi Health Commercial |
$2,697.82
|
| Rate for Payer: PACE SWMI |
$2,248.18
|
| Rate for Payer: PHP Medicare Advantage |
$2,248.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,188.90
|
| Rate for Payer: Priority Health Medicare |
$2,270.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,248.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,248.18
|
| Rate for Payer: UHC Exchange |
$2,248.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,248.18
|
|
|
PR CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST
|
Professional
|
Both
|
$4,911.00
|
|
|
Service Code
|
HCPCS 51590
|
| Min. Negotiated Rate |
$1,839.43 |
| Max. Negotiated Rate |
$3,192.15 |
| Rate for Payer: Aetna Commercial |
$2,464.84
|
| Rate for Payer: Aetna Medicare |
$1,913.01
|
| Rate for Payer: BCBS Complete |
$1,964.40
|
| Rate for Payer: BCBS MAPPO |
$1,839.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,839.43
|
| Rate for Payer: Cash Price |
$3,928.80
|
| Rate for Payer: Cash Price |
$3,928.80
|
| Rate for Payer: Cofinity Commercial |
$2,648.78
|
| Rate for Payer: Cofinity Commercial |
$2,464.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,839.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,931.40
|
| Rate for Payer: Nomi Health Commercial |
$2,207.32
|
| Rate for Payer: PACE SWMI |
$1,839.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,839.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,192.15
|
| Rate for Payer: Priority Health Medicare |
$1,857.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,839.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,839.43
|
| Rate for Payer: UHC Exchange |
$1,839.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,839.43
|
|
|
PR CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 51565
|
| Min. Negotiated Rate |
$1,060.80 |
| Max. Negotiated Rate |
$1,768.45 |
| Rate for Payer: Aetna Commercial |
$1,645.64
|
| Rate for Payer: Aetna Medicare |
$1,277.21
|
| Rate for Payer: BCBS Complete |
$1,060.80
|
| Rate for Payer: BCBS MAPPO |
$1,228.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,228.09
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cofinity Commercial |
$1,768.45
|
| Rate for Payer: Cofinity Commercial |
$1,645.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,228.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,289.49
|
| Rate for Payer: Nomi Health Commercial |
$1,473.71
|
| Rate for Payer: PACE SWMI |
$1,228.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,228.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
| Rate for Payer: Priority Health Medicare |
$1,240.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,228.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,228.09
|
| Rate for Payer: UHC Exchange |
$1,228.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,228.09
|
|
|
PR CSTOPLASTY/CSTOURTP PLSTC ANY
|
Professional
|
Both
|
$1,135.00
|
|
|
Service Code
|
HCPCS 51800
|
| Min. Negotiated Rate |
$454.00 |
| Max. Negotiated Rate |
$1,425.82 |
| Rate for Payer: Aetna Commercial |
$1,326.80
|
| Rate for Payer: Aetna Medicare |
$1,029.76
|
| Rate for Payer: BCBS Complete |
$454.00
|
| Rate for Payer: BCBS MAPPO |
$990.15
|
| Rate for Payer: BCN Medicare Advantage |
$990.15
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Cofinity Commercial |
$1,425.82
|
| Rate for Payer: Cofinity Commercial |
$1,326.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$990.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,039.66
|
| Rate for Payer: Nomi Health Commercial |
$1,188.18
|
| Rate for Payer: PACE SWMI |
$990.15
|
| Rate for Payer: PHP Medicare Advantage |
$990.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.75
|
| Rate for Payer: Priority Health Medicare |
$1,000.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$990.15
|
| Rate for Payer: UHC Exchange |
$990.15
|
| Rate for Payer: UHC Medicare Advantage |
$990.15
|
|
|
PR CSTOURTP W/UNI/BI URTRONEOCSTOST
|
Professional
|
Both
|
$2,417.00
|
|
|
Service Code
|
HCPCS 51820
|
| Min. Negotiated Rate |
$966.80 |
| Max. Negotiated Rate |
$1,571.05 |
| Rate for Payer: Aetna Commercial |
$1,386.98
|
| Rate for Payer: Aetna Medicare |
$1,076.46
|
| Rate for Payer: BCBS Complete |
$966.80
|
| Rate for Payer: BCBS MAPPO |
$1,035.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,035.06
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Cofinity Commercial |
$1,490.49
|
| Rate for Payer: Cofinity Commercial |
$1,386.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,035.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,086.81
|
| Rate for Payer: Nomi Health Commercial |
$1,242.07
|
| Rate for Payer: PACE SWMI |
$1,035.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,035.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.05
|
| Rate for Payer: Priority Health Medicare |
$1,045.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,035.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,035.06
|
| Rate for Payer: UHC Exchange |
$1,035.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,035.06
|
|
|
PR CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
|
Professional
|
Both
|
$937.00
|
|
|
Service Code
|
HCPCS 42972
|
| Min. Negotiated Rate |
$374.80 |
| Max. Negotiated Rate |
$696.79 |
| Rate for Payer: Aetna Commercial |
$648.40
|
| Rate for Payer: Aetna Medicare |
$503.24
|
| Rate for Payer: BCBS Complete |
$374.80
|
| Rate for Payer: BCBS MAPPO |
$483.88
|
| Rate for Payer: BCN Medicare Advantage |
$483.88
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Cofinity Commercial |
$648.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$483.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.07
|
| Rate for Payer: Nomi Health Commercial |
$580.66
|
| Rate for Payer: PACE SWMI |
$483.88
|
| Rate for Payer: PHP Medicare Advantage |
$483.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$609.05
|
| Rate for Payer: Priority Health Medicare |
$488.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$483.88
|
| Rate for Payer: UHC Exchange |
$483.88
|
| Rate for Payer: UHC Medicare Advantage |
$483.88
|
|
|
PR CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS
|
Professional
|
Both
|
$749.00
|
|
|
Service Code
|
HCPCS 42970
|
| Min. Negotiated Rate |
$299.60 |
| Max. Negotiated Rate |
$563.95 |
| Rate for Payer: Aetna Commercial |
$524.78
|
| Rate for Payer: Aetna Medicare |
$407.30
|
| Rate for Payer: BCBS Complete |
$299.60
|
| Rate for Payer: BCBS MAPPO |
$391.63
|
| Rate for Payer: BCN Medicare Advantage |
$391.63
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cofinity Commercial |
$563.95
|
| Rate for Payer: Cofinity Commercial |
$524.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.21
|
| Rate for Payer: Nomi Health Commercial |
$469.96
|
| Rate for Payer: PACE SWMI |
$391.63
|
| Rate for Payer: PHP Medicare Advantage |
$391.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.85
|
| Rate for Payer: Priority Health Medicare |
$395.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.63
|
| Rate for Payer: UHC Exchange |
$391.63
|
| Rate for Payer: UHC Medicare Advantage |
$391.63
|
|
|
PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 30905
|
| Min. Negotiated Rate |
$102.72 |
| Max. Negotiated Rate |
$373.75 |
| Rate for Payer: Aetna Commercial |
$137.64
|
| Rate for Payer: Aetna Medicare |
$106.83
|
| Rate for Payer: BCBS Complete |
$230.00
|
| Rate for Payer: BCBS MAPPO |
$102.72
|
| Rate for Payer: BCN Medicare Advantage |
$102.72
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cofinity Commercial |
$147.92
|
| Rate for Payer: Cofinity Commercial |
$137.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.86
|
| Rate for Payer: Nomi Health Commercial |
$123.26
|
| Rate for Payer: PACE SWMI |
$102.72
|
| Rate for Payer: PHP Medicare Advantage |
$102.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.75
|
| Rate for Payer: Priority Health Medicare |
$103.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.72
|
| Rate for Payer: UHC Exchange |
$102.72
|
| Rate for Payer: UHC Medicare Advantage |
$102.72
|
|
|
PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ
|
Professional
|
Both
|
$599.00
|
|
|
Service Code
|
HCPCS 30906
|
| Min. Negotiated Rate |
$127.39 |
| Max. Negotiated Rate |
$389.35 |
| Rate for Payer: Aetna Commercial |
$170.70
|
| Rate for Payer: Aetna Medicare |
$132.49
|
| Rate for Payer: BCBS Complete |
$239.60
|
| Rate for Payer: BCBS MAPPO |
$127.39
|
| Rate for Payer: BCN Medicare Advantage |
$127.39
|
| Rate for Payer: Cash Price |
$479.20
|
| Rate for Payer: Cash Price |
$479.20
|
| Rate for Payer: Cofinity Commercial |
$183.44
|
| Rate for Payer: Cofinity Commercial |
$170.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.76
|
| Rate for Payer: Nomi Health Commercial |
$152.87
|
| Rate for Payer: PACE SWMI |
$127.39
|
| Rate for Payer: PHP Medicare Advantage |
$127.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.35
|
| Rate for Payer: Priority Health Medicare |
$128.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.39
|
| Rate for Payer: UHC Exchange |
$127.39
|
| Rate for Payer: UHC Medicare Advantage |
$127.39
|
|
|
PR CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ
|
Professional
|
Both
|
$780.00
|
|
|
Service Code
|
HCPCS 42961
|
| Min. Negotiated Rate |
$312.00 |
| Max. Negotiated Rate |
$574.23 |
| Rate for Payer: Aetna Commercial |
$534.35
|
| Rate for Payer: Aetna Medicare |
$414.72
|
| Rate for Payer: BCBS Complete |
$312.00
|
| Rate for Payer: BCBS MAPPO |
$398.77
|
| Rate for Payer: BCN Medicare Advantage |
$398.77
|
| Rate for Payer: Cash Price |
$624.00
|
| Rate for Payer: Cash Price |
$624.00
|
| Rate for Payer: Cofinity Commercial |
$574.23
|
| Rate for Payer: Cofinity Commercial |
$534.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.71
|
| Rate for Payer: Nomi Health Commercial |
$478.52
|
| Rate for Payer: PACE SWMI |
$398.77
|
| Rate for Payer: PHP Medicare Advantage |
$398.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$507.00
|
| Rate for Payer: Priority Health Medicare |
$402.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$398.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$398.77
|
| Rate for Payer: UHC Exchange |
$398.77
|
| Rate for Payer: UHC Medicare Advantage |
$398.77
|
|
|
PR CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
|
Professional
|
Both
|
$1,901.00
|
|
|
Service Code
|
HCPCS 42962
|
| Min. Negotiated Rate |
$492.46 |
| Max. Negotiated Rate |
$1,235.65 |
| Rate for Payer: Aetna Commercial |
$659.90
|
| Rate for Payer: Aetna Medicare |
$512.16
|
| Rate for Payer: BCBS Complete |
$760.40
|
| Rate for Payer: BCBS MAPPO |
$492.46
|
| Rate for Payer: BCN Medicare Advantage |
$492.46
|
| Rate for Payer: Cash Price |
$1,520.80
|
| Rate for Payer: Cash Price |
$1,520.80
|
| Rate for Payer: Cofinity Commercial |
$709.14
|
| Rate for Payer: Cofinity Commercial |
$659.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.08
|
| Rate for Payer: Nomi Health Commercial |
$590.95
|
| Rate for Payer: PACE SWMI |
$492.46
|
| Rate for Payer: PHP Medicare Advantage |
$492.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.65
|
| Rate for Payer: Priority Health Medicare |
$497.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$492.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$492.46
|
| Rate for Payer: UHC Exchange |
$492.46
|
| Rate for Payer: UHC Medicare Advantage |
$492.46
|
|
