|
PR CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY
|
Professional
|
Both
|
$3,796.00
|
|
|
Service Code
|
HCPCS 51575
|
| Min. Negotiated Rate |
$1,152.97 |
| Max. Negotiated Rate |
$3,111.16 |
| Rate for Payer: Aetna Commercial |
$2,316.16
|
| Rate for Payer: Aetna Medicare |
$1,797.62
|
| Rate for Payer: BCBS Complete |
$1,210.62
|
| Rate for Payer: BCBS MAPPO |
$1,728.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,111.16
|
| Rate for Payer: BCN Commercial |
$2,610.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,728.48
|
| Rate for Payer: Cash Price |
$3,036.80
|
| Rate for Payer: Cash Price |
$3,036.80
|
| Rate for Payer: Cofinity Commercial |
$2,489.01
|
| Rate for Payer: Cofinity Commercial |
$2,316.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,728.48
|
| Rate for Payer: Mclaren Medicaid |
$1,152.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,814.90
|
| Rate for Payer: Meridian Medicaid |
$1,210.62
|
| Rate for Payer: Nomi Health Commercial |
$2,074.18
|
| Rate for Payer: PACE SWMI |
$1,728.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,728.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,152.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,467.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,866.45
|
| Rate for Payer: Priority Health Medicare |
$1,745.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,866.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,728.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,728.48
|
| Rate for Payer: UHC Exchange |
$1,728.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,728.48
|
| Rate for Payer: UHCCP Medicaid |
$1,152.97
|
|
|
PR CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS
|
Professional
|
Both
|
$773.00
|
|
|
Service Code
|
HCPCS 52281
|
| Min. Negotiated Rate |
$96.70 |
| Max. Negotiated Rate |
$2,364.67 |
| Rate for Payer: Aetna Commercial |
$193.74
|
| Rate for Payer: Aetna Medicare |
$150.36
|
| Rate for Payer: BCBS Complete |
$101.54
|
| Rate for Payer: BCBS MAPPO |
$144.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,364.67
|
| Rate for Payer: BCN Commercial |
$478.42
|
| Rate for Payer: BCN Medicare Advantage |
$144.58
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cofinity Commercial |
$208.20
|
| Rate for Payer: Cofinity Commercial |
$193.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.58
|
| Rate for Payer: Mclaren Medicaid |
$96.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.81
|
| Rate for Payer: Meridian Medicaid |
$101.54
|
| Rate for Payer: Nomi Health Commercial |
$173.50
|
| Rate for Payer: PACE SWMI |
$144.58
|
| Rate for Payer: PHP Medicare Advantage |
$144.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$502.45
|
| Rate for Payer: Priority Health HMO/PPO |
$239.66
|
| Rate for Payer: Priority Health Medicare |
$146.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.58
|
| Rate for Payer: UHC Exchange |
$144.58
|
| Rate for Payer: UHC Medicare Advantage |
$144.58
|
| Rate for Payer: UHCCP Medicaid |
$96.70
|
|
|
PR CYSTO FRAGMENTATION URETERAL STONE
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
HCPCS 52325
|
| Min. Negotiated Rate |
$201.92 |
| Max. Negotiated Rate |
$4,083.76 |
| Rate for Payer: Aetna Commercial |
$406.46
|
| Rate for Payer: Aetna Medicare |
$315.46
|
| Rate for Payer: BCBS Complete |
$212.02
|
| Rate for Payer: BCBS MAPPO |
$303.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,083.76
|
| Rate for Payer: BCN Commercial |
$456.42
|
| Rate for Payer: BCN Medicare Advantage |
$303.33
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$406.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.33
|
| Rate for Payer: Mclaren Medicaid |
$201.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.50
|
| Rate for Payer: Meridian Medicaid |
$212.02
|
| Rate for Payer: Nomi Health Commercial |
$364.00
|
| Rate for Payer: PACE SWMI |
$303.33
|
| Rate for Payer: PHP Medicare Advantage |
$303.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health HMO/PPO |
$501.71
|
| Rate for Payer: Priority Health Medicare |
$306.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$501.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.33
|
| Rate for Payer: UHC Exchange |
$303.33
|
| Rate for Payer: UHC Medicare Advantage |
$303.33
|
| Rate for Payer: UHCCP Medicaid |
$201.92
|
|
|
PR CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
HCPCS 52305
|
| Min. Negotiated Rate |
$175.51 |
| Max. Negotiated Rate |
$894.94 |
| Rate for Payer: Aetna Commercial |
$352.97
|
| Rate for Payer: Aetna Medicare |
$273.95
|
| Rate for Payer: BCBS Complete |
$184.29
|
| Rate for Payer: BCBS MAPPO |
$263.41
|
| Rate for Payer: BCBS Trust/PPO |
$894.94
|
| Rate for Payer: BCN Commercial |
$397.79
|
| Rate for Payer: BCN Medicare Advantage |
$263.41
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cofinity Commercial |
$379.31
|
| Rate for Payer: Cofinity Commercial |
$352.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.41
|
| Rate for Payer: Mclaren Medicaid |
$175.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.58
|
| Rate for Payer: Meridian Medicaid |
$184.29
|
| Rate for Payer: Nomi Health Commercial |
$316.09
|
| Rate for Payer: PACE SWMI |
$263.41
|
| Rate for Payer: PHP Medicare Advantage |
$263.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.55
|
| Rate for Payer: Priority Health HMO/PPO |
$436.19
|
| Rate for Payer: Priority Health Medicare |
$266.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$436.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.41
|
| Rate for Payer: UHC Exchange |
$263.41
|
| Rate for Payer: UHC Medicare Advantage |
$263.41
|
| Rate for Payer: UHCCP Medicaid |
$175.51
|
|
|
PR CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL
|
Professional
|
Both
|
$1,720.00
|
|
|
Service Code
|
HCPCS 52442
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$1,276.43 |
| Rate for Payer: Aetna Commercial |
$65.00
|
| Rate for Payer: Aetna Medicare |
$50.45
|
| Rate for Payer: BCBS Complete |
$33.77
|
| Rate for Payer: BCBS MAPPO |
$48.51
|
| Rate for Payer: BCBS Trust/PPO |
$367.70
|
| Rate for Payer: BCN Commercial |
$1,276.43
|
| Rate for Payer: BCN Medicare Advantage |
$48.51
|
| Rate for Payer: Cash Price |
$1,376.00
|
| Rate for Payer: Cash Price |
$1,376.00
|
| Rate for Payer: Cofinity Commercial |
$69.85
|
| Rate for Payer: Cofinity Commercial |
$65.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.51
|
| Rate for Payer: Mclaren Medicaid |
$32.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.94
|
| Rate for Payer: Meridian Medicaid |
$33.77
|
| Rate for Payer: Nomi Health Commercial |
$58.21
|
| Rate for Payer: PACE SWMI |
$48.51
|
| Rate for Payer: PHP Medicare Advantage |
$48.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.00
|
| Rate for Payer: Priority Health HMO/PPO |
$79.36
|
| Rate for Payer: Priority Health Medicare |
$49.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.51
|
| Rate for Payer: UHC Exchange |
$48.51
|
| Rate for Payer: UHC Medicare Advantage |
$48.51
|
| Rate for Payer: UHCCP Medicaid |
$32.16
|
|
|
PR CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE
|
Professional
|
Both
|
$2,248.00
|
|
|
Service Code
|
HCPCS 52441
|
| Min. Negotiated Rate |
$132.91 |
| Max. Negotiated Rate |
$1,866.75 |
| Rate for Payer: Aetna Commercial |
$267.50
|
| Rate for Payer: Aetna Medicare |
$207.62
|
| Rate for Payer: BCBS Complete |
$139.56
|
| Rate for Payer: BCBS MAPPO |
$199.63
|
| Rate for Payer: BCBS Trust/PPO |
$528.83
|
| Rate for Payer: BCN Commercial |
$1,866.75
|
| Rate for Payer: BCN Medicare Advantage |
$199.63
|
| Rate for Payer: Cash Price |
$1,798.40
|
| Rate for Payer: Cash Price |
$1,798.40
|
| Rate for Payer: Cofinity Commercial |
$287.47
|
| Rate for Payer: Cofinity Commercial |
$267.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.63
|
| Rate for Payer: Mclaren Medicaid |
$132.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.61
|
| Rate for Payer: Meridian Medicaid |
$139.56
|
| Rate for Payer: Nomi Health Commercial |
$239.56
|
| Rate for Payer: PACE SWMI |
$199.63
|
| Rate for Payer: PHP Medicare Advantage |
$199.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,461.20
|
| Rate for Payer: Priority Health HMO/PPO |
$329.15
|
| Rate for Payer: Priority Health Medicare |
$201.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.63
|
| Rate for Payer: UHC Exchange |
$199.63
|
| Rate for Payer: UHC Medicare Advantage |
$199.63
|
| Rate for Payer: UHCCP Medicaid |
$132.91
|
|
|
PR CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR
|
Professional
|
Both
|
$944.00
|
|
|
Service Code
|
HCPCS 52334
|
| Min. Negotiated Rate |
$116.30 |
| Max. Negotiated Rate |
$2,807.39 |
| Rate for Payer: Aetna Commercial |
$233.36
|
| Rate for Payer: Aetna Medicare |
$181.12
|
| Rate for Payer: BCBS Complete |
$122.12
|
| Rate for Payer: BCBS MAPPO |
$174.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,807.39
|
| Rate for Payer: BCN Commercial |
$261.44
|
| Rate for Payer: BCN Medicare Advantage |
$174.15
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cofinity Commercial |
$250.78
|
| Rate for Payer: Cofinity Commercial |
$233.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.15
|
| Rate for Payer: Mclaren Medicaid |
$116.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.86
|
| Rate for Payer: Meridian Medicaid |
$122.12
|
| Rate for Payer: Nomi Health Commercial |
$208.98
|
| Rate for Payer: PACE SWMI |
$174.15
|
| Rate for Payer: PHP Medicare Advantage |
$174.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.60
|
| Rate for Payer: Priority Health HMO/PPO |
$287.07
|
| Rate for Payer: Priority Health Medicare |
$175.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.15
|
| Rate for Payer: UHC Exchange |
$174.15
|
| Rate for Payer: UHC Medicare Advantage |
$174.15
|
| Rate for Payer: UHCCP Medicaid |
$116.30
|
|
|
PR CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 51050
|
| Min. Negotiated Rate |
$304.59 |
| Max. Negotiated Rate |
$3,253.27 |
| Rate for Payer: Aetna Commercial |
$606.54
|
| Rate for Payer: Aetna Medicare |
$470.75
|
| Rate for Payer: BCBS Complete |
$319.82
|
| Rate for Payer: BCBS MAPPO |
$452.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.27
|
| Rate for Payer: BCN Commercial |
$682.20
|
| Rate for Payer: BCN Medicare Advantage |
$452.64
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cofinity Commercial |
$651.80
|
| Rate for Payer: Cofinity Commercial |
$606.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.64
|
| Rate for Payer: Mclaren Medicaid |
$304.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$475.27
|
| Rate for Payer: Meridian Medicaid |
$319.82
|
| Rate for Payer: Nomi Health Commercial |
$543.17
|
| Rate for Payer: PACE SWMI |
$452.64
|
| Rate for Payer: PHP Medicare Advantage |
$452.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health HMO/PPO |
$755.23
|
| Rate for Payer: Priority Health Medicare |
$457.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$755.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$452.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$452.64
|
| Rate for Payer: UHC Exchange |
$452.64
|
| Rate for Payer: UHC Medicare Advantage |
$452.64
|
| Rate for Payer: UHCCP Medicaid |
$304.59
|
|
|
PR CYSTO MANJ W/O RMVL URETERAL STONE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 52330
|
| Min. Negotiated Rate |
$166.35 |
| Max. Negotiated Rate |
$6,449.49 |
| Rate for Payer: Aetna Commercial |
$334.72
|
| Rate for Payer: Aetna Medicare |
$259.78
|
| Rate for Payer: BCBS Complete |
$174.67
|
| Rate for Payer: BCBS MAPPO |
$249.79
|
| Rate for Payer: BCBS Trust/PPO |
$6,449.49
|
| Rate for Payer: BCN Commercial |
$884.01
|
| Rate for Payer: BCN Medicare Advantage |
$249.79
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$359.70
|
| Rate for Payer: Cofinity Commercial |
$334.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.79
|
| Rate for Payer: Mclaren Medicaid |
$166.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.28
|
| Rate for Payer: Meridian Medicaid |
$174.67
|
| Rate for Payer: Nomi Health Commercial |
$299.75
|
| Rate for Payer: PACE SWMI |
$249.79
|
| Rate for Payer: PHP Medicare Advantage |
$249.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health HMO/PPO |
$413.30
|
| Rate for Payer: Priority Health Medicare |
$252.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$249.79
|
| Rate for Payer: UHC Exchange |
$249.79
|
| Rate for Payer: UHC Medicare Advantage |
$249.79
|
| Rate for Payer: UHCCP Medicaid |
$166.35
|
|
|
PR CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION
|
Professional
|
Both
|
$762.00
|
|
|
Service Code
|
HCPCS 52354
|
| Min. Negotiated Rate |
$263.48 |
| Max. Negotiated Rate |
$654.03 |
| Rate for Payer: Aetna Commercial |
$530.44
|
| Rate for Payer: Aetna Medicare |
$411.68
|
| Rate for Payer: BCBS Complete |
$276.65
|
| Rate for Payer: BCBS MAPPO |
$395.85
|
| Rate for Payer: BCBS Trust/PPO |
$475.77
|
| Rate for Payer: BCN Commercial |
$593.74
|
| Rate for Payer: BCN Medicare Advantage |
$395.85
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cofinity Commercial |
$570.02
|
| Rate for Payer: Cofinity Commercial |
$530.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.85
|
| Rate for Payer: Mclaren Medicaid |
$263.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.64
|
| Rate for Payer: Meridian Medicaid |
$276.65
|
| Rate for Payer: Nomi Health Commercial |
$475.02
|
| Rate for Payer: PACE SWMI |
$395.85
|
| Rate for Payer: PHP Medicare Advantage |
$395.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.30
|
| Rate for Payer: Priority Health HMO/PPO |
$654.03
|
| Rate for Payer: Priority Health Medicare |
$399.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$654.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.85
|
| Rate for Payer: UHC Exchange |
$395.85
|
| Rate for Payer: UHC Medicare Advantage |
$395.85
|
| Rate for Payer: UHCCP Medicaid |
$263.48
|
|
|
PR CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR
|
Professional
|
Both
|
$1,452.00
|
|
|
Service Code
|
HCPCS 52355
|
| Min. Negotiated Rate |
$295.22 |
| Max. Negotiated Rate |
$7,524.58 |
| Rate for Payer: Aetna Commercial |
$594.49
|
| Rate for Payer: Aetna Medicare |
$461.40
|
| Rate for Payer: BCBS Complete |
$309.98
|
| Rate for Payer: BCBS MAPPO |
$443.65
|
| Rate for Payer: BCBS Trust/PPO |
$7,524.58
|
| Rate for Payer: BCN Commercial |
$665.09
|
| Rate for Payer: BCN Medicare Advantage |
$443.65
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cofinity Commercial |
$638.86
|
| Rate for Payer: Cofinity Commercial |
$594.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.65
|
| Rate for Payer: Mclaren Medicaid |
$295.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$465.83
|
| Rate for Payer: Meridian Medicaid |
$309.98
|
| Rate for Payer: Nomi Health Commercial |
$532.38
|
| Rate for Payer: PACE SWMI |
$443.65
|
| Rate for Payer: PHP Medicare Advantage |
$443.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$943.80
|
| Rate for Payer: Priority Health HMO/PPO |
$732.86
|
| Rate for Payer: Priority Health Medicare |
$448.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.65
|
| Rate for Payer: UHC Exchange |
$443.65
|
| Rate for Payer: UHC Medicare Advantage |
$443.65
|
| Rate for Payer: UHCCP Medicaid |
$295.22
|
|
|
PR CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED
|
Professional
|
Both
|
$3,197.00
|
|
|
Service Code
|
HCPCS 51865
|
| Min. Negotiated Rate |
$571.91 |
| Max. Negotiated Rate |
$2,078.05 |
| Rate for Payer: Aetna Commercial |
$1,145.35
|
| Rate for Payer: Aetna Medicare |
$888.93
|
| Rate for Payer: BCBS Complete |
$600.51
|
| Rate for Payer: BCBS MAPPO |
$854.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,532.07
|
| Rate for Payer: BCN Commercial |
$1,294.51
|
| Rate for Payer: BCN Medicare Advantage |
$854.74
|
| Rate for Payer: Cash Price |
$2,557.60
|
| Rate for Payer: Cash Price |
$2,557.60
|
| Rate for Payer: Cofinity Commercial |
$1,230.83
|
| Rate for Payer: Cofinity Commercial |
$1,145.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.74
|
| Rate for Payer: Mclaren Medicaid |
$571.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.48
|
| Rate for Payer: Meridian Medicaid |
$600.51
|
| Rate for Payer: Nomi Health Commercial |
$1,025.69
|
| Rate for Payer: PACE SWMI |
$854.74
|
| Rate for Payer: PHP Medicare Advantage |
$854.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,078.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,424.70
|
| Rate for Payer: Priority Health Medicare |
$863.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,424.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$854.74
|
| Rate for Payer: UHC Exchange |
$854.74
|
| Rate for Payer: UHC Medicare Advantage |
$854.74
|
| Rate for Payer: UHCCP Medicaid |
$571.91
|
|
|
PR CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE
|
Professional
|
Both
|
$2,448.00
|
|
|
Service Code
|
HCPCS 51860
|
| Min. Negotiated Rate |
$476.91 |
| Max. Negotiated Rate |
$2,379.46 |
| Rate for Payer: Aetna Commercial |
$954.40
|
| Rate for Payer: Aetna Medicare |
$740.73
|
| Rate for Payer: BCBS Complete |
$500.76
|
| Rate for Payer: BCBS MAPPO |
$712.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,379.46
|
| Rate for Payer: BCN Commercial |
$1,080.96
|
| Rate for Payer: BCN Medicare Advantage |
$712.24
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$1,025.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.24
|
| Rate for Payer: Mclaren Medicaid |
$476.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$747.85
|
| Rate for Payer: Meridian Medicaid |
$500.76
|
| Rate for Payer: Nomi Health Commercial |
$854.69
|
| Rate for Payer: PACE SWMI |
$712.24
|
| Rate for Payer: PHP Medicare Advantage |
$712.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,189.82
|
| Rate for Payer: Priority Health Medicare |
$719.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,189.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$712.24
|
| Rate for Payer: UHC Exchange |
$712.24
|
| Rate for Payer: UHC Medicare Advantage |
$712.24
|
| Rate for Payer: UHCCP Medicaid |
$476.91
|
|
|
PR CYSTOSTOMY CYSTOTOMY W/DRAINAGE
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 51040
|
| Min. Negotiated Rate |
$188.72 |
| Max. Negotiated Rate |
$3,051.99 |
| Rate for Payer: Aetna Commercial |
$373.42
|
| Rate for Payer: Aetna Medicare |
$289.82
|
| Rate for Payer: BCBS Complete |
$198.16
|
| Rate for Payer: BCBS MAPPO |
$278.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,051.99
|
| Rate for Payer: BCN Commercial |
$422.22
|
| Rate for Payer: BCN Medicare Advantage |
$278.67
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$401.28
|
| Rate for Payer: Cofinity Commercial |
$373.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.67
|
| Rate for Payer: Mclaren Medicaid |
$188.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.60
|
| Rate for Payer: Meridian Medicaid |
$198.16
|
| Rate for Payer: Nomi Health Commercial |
$334.40
|
| Rate for Payer: PACE SWMI |
$278.67
|
| Rate for Payer: PHP Medicare Advantage |
$278.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO |
$468.69
|
| Rate for Payer: Priority Health Medicare |
$281.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$468.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$278.67
|
| Rate for Payer: UHC Exchange |
$278.67
|
| Rate for Payer: UHC Medicare Advantage |
$278.67
|
| Rate for Payer: UHCCP Medicaid |
$188.72
|
|
|
PR CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL
|
Professional
|
Both
|
$2,450.00
|
|
|
Service Code
|
HCPCS 51020
|
| Min. Negotiated Rate |
$303.10 |
| Max. Negotiated Rate |
$3,049.88 |
| Rate for Payer: Aetna Commercial |
$601.90
|
| Rate for Payer: Aetna Medicare |
$467.15
|
| Rate for Payer: BCBS Complete |
$318.26
|
| Rate for Payer: BCBS MAPPO |
$449.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,049.88
|
| Rate for Payer: BCN Commercial |
$680.73
|
| Rate for Payer: BCN Medicare Advantage |
$449.18
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cofinity Commercial |
$646.82
|
| Rate for Payer: Cofinity Commercial |
$601.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.18
|
| Rate for Payer: Mclaren Medicaid |
$303.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.64
|
| Rate for Payer: Meridian Medicaid |
$318.26
|
| Rate for Payer: Nomi Health Commercial |
$539.02
|
| Rate for Payer: PACE SWMI |
$449.18
|
| Rate for Payer: PHP Medicare Advantage |
$449.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,592.50
|
| Rate for Payer: Priority Health HMO/PPO |
$754.16
|
| Rate for Payer: Priority Health Medicare |
$453.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$754.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.18
|
| Rate for Payer: UHC Exchange |
$449.18
|
| Rate for Payer: UHC Medicare Advantage |
$449.18
|
| Rate for Payer: UHCCP Medicaid |
$303.10
|
|
|
PR CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE
|
Professional
|
Both
|
$2,002.00
|
|
|
Service Code
|
HCPCS 51525
|
| Min. Negotiated Rate |
$548.48 |
| Max. Negotiated Rate |
$3,181.95 |
| Rate for Payer: Aetna Commercial |
$1,097.85
|
| Rate for Payer: Aetna Medicare |
$852.06
|
| Rate for Payer: BCBS Complete |
$575.90
|
| Rate for Payer: BCBS MAPPO |
$819.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,181.95
|
| Rate for Payer: BCN Commercial |
$1,239.29
|
| Rate for Payer: BCN Medicare Advantage |
$819.29
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cofinity Commercial |
$1,179.78
|
| Rate for Payer: Cofinity Commercial |
$1,097.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.29
|
| Rate for Payer: Mclaren Medicaid |
$548.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$860.25
|
| Rate for Payer: Meridian Medicaid |
$575.90
|
| Rate for Payer: Nomi Health Commercial |
$983.15
|
| Rate for Payer: PACE SWMI |
$819.29
|
| Rate for Payer: PHP Medicare Advantage |
$819.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,301.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,362.38
|
| Rate for Payer: Priority Health Medicare |
$827.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,362.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$819.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$819.29
|
| Rate for Payer: UHC Exchange |
$819.29
|
| Rate for Payer: UHC Medicare Advantage |
$819.29
|
| Rate for Payer: UHCCP Medicaid |
$548.48
|
|
|
PR CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 51535
|
| Min. Negotiated Rate |
$499.49 |
| Max. Negotiated Rate |
$3,177.20 |
| Rate for Payer: Aetna Commercial |
$998.77
|
| Rate for Payer: Aetna Medicare |
$775.16
|
| Rate for Payer: BCBS Complete |
$524.46
|
| Rate for Payer: BCBS MAPPO |
$745.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,177.20
|
| Rate for Payer: BCN Commercial |
$1,124.45
|
| Rate for Payer: BCN Medicare Advantage |
$745.35
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cofinity Commercial |
$998.77
|
| Rate for Payer: Cofinity Commercial |
$1,073.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.35
|
| Rate for Payer: Mclaren Medicaid |
$499.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$782.62
|
| Rate for Payer: Meridian Medicaid |
$524.46
|
| Rate for Payer: Nomi Health Commercial |
$894.42
|
| Rate for Payer: PACE SWMI |
$745.35
|
| Rate for Payer: PHP Medicare Advantage |
$745.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,239.89
|
| Rate for Payer: Priority Health Medicare |
$752.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,239.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$745.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$745.35
|
| Rate for Payer: UHC Exchange |
$745.35
|
| Rate for Payer: UHC Medicare Advantage |
$745.35
|
| Rate for Payer: UHCCP Medicaid |
$499.49
|
|
|
PR CYSTOTOMY EXCISION BLADDER TUMOR
|
Professional
|
Both
|
$1,390.00
|
|
|
Service Code
|
HCPCS 51530
|
| Min. Negotiated Rate |
$493.10 |
| Max. Negotiated Rate |
$2,404.29 |
| Rate for Payer: Aetna Commercial |
$985.74
|
| Rate for Payer: Aetna Medicare |
$765.06
|
| Rate for Payer: BCBS Complete |
$517.76
|
| Rate for Payer: BCBS MAPPO |
$735.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,404.29
|
| Rate for Payer: BCN Commercial |
$1,110.28
|
| Rate for Payer: BCN Medicare Advantage |
$735.63
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cofinity Commercial |
$985.74
|
| Rate for Payer: Cofinity Commercial |
$1,059.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.63
|
| Rate for Payer: Mclaren Medicaid |
$493.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$772.41
|
| Rate for Payer: Meridian Medicaid |
$517.76
|
| Rate for Payer: Nomi Health Commercial |
$882.76
|
| Rate for Payer: PACE SWMI |
$735.63
|
| Rate for Payer: PHP Medicare Advantage |
$735.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$903.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,224.98
|
| Rate for Payer: Priority Health Medicare |
$742.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,224.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$735.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$735.63
|
| Rate for Payer: UHC Exchange |
$735.63
|
| Rate for Payer: UHC Medicare Advantage |
$735.63
|
| Rate for Payer: UHCCP Medicaid |
$493.10
|
|
|
PR CYSTOTOMY SIMPLE EXCISION VESICAL NECK
|
Professional
|
Both
|
$1,228.00
|
|
|
Service Code
|
HCPCS 51520
|
| Min. Negotiated Rate |
$383.19 |
| Max. Negotiated Rate |
$3,020.82 |
| Rate for Payer: Aetna Commercial |
$763.83
|
| Rate for Payer: Aetna Medicare |
$592.82
|
| Rate for Payer: BCBS Complete |
$402.35
|
| Rate for Payer: BCBS MAPPO |
$570.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,020.82
|
| Rate for Payer: BCN Commercial |
$861.05
|
| Rate for Payer: BCN Medicare Advantage |
$570.02
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cofinity Commercial |
$820.83
|
| Rate for Payer: Cofinity Commercial |
$763.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.02
|
| Rate for Payer: Mclaren Medicaid |
$383.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$598.52
|
| Rate for Payer: Meridian Medicaid |
$402.35
|
| Rate for Payer: Nomi Health Commercial |
$684.02
|
| Rate for Payer: PACE SWMI |
$570.02
|
| Rate for Payer: PHP Medicare Advantage |
$570.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.20
|
| Rate for Payer: Priority Health HMO/PPO |
$951.22
|
| Rate for Payer: Priority Health Medicare |
$575.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$951.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$570.02
|
| Rate for Payer: UHC Exchange |
$570.02
|
| Rate for Payer: UHC Medicare Advantage |
$570.02
|
| Rate for Payer: UHCCP Medicaid |
$383.19
|
|
|
PR CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 51065
|
| Min. Negotiated Rate |
$373.39 |
| Max. Negotiated Rate |
$2,864.97 |
| Rate for Payer: Aetna Commercial |
$744.33
|
| Rate for Payer: Aetna Medicare |
$577.69
|
| Rate for Payer: BCBS Complete |
$392.06
|
| Rate for Payer: BCBS MAPPO |
$555.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,864.97
|
| Rate for Payer: BCN Commercial |
$839.06
|
| Rate for Payer: BCN Medicare Advantage |
$555.47
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$799.88
|
| Rate for Payer: Cofinity Commercial |
$744.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.47
|
| Rate for Payer: Mclaren Medicaid |
$373.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$583.24
|
| Rate for Payer: Meridian Medicaid |
$392.06
|
| Rate for Payer: Nomi Health Commercial |
$666.56
|
| Rate for Payer: PACE SWMI |
$555.47
|
| Rate for Payer: PHP Medicare Advantage |
$555.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$373.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.85
|
| Rate for Payer: Priority Health HMO/PPO |
$927.26
|
| Rate for Payer: Priority Health Medicare |
$561.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$927.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$555.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$555.47
|
| Rate for Payer: UHC Exchange |
$555.47
|
| Rate for Payer: UHC Medicare Advantage |
$555.47
|
| Rate for Payer: UHCCP Medicaid |
$373.39
|
|
|
PR CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX
|
Professional
|
Both
|
$1,032.00
|
|
|
Service Code
|
HCPCS 51045
|
| Min. Negotiated Rate |
$316.52 |
| Max. Negotiated Rate |
$3,133.88 |
| Rate for Payer: Aetna Commercial |
$630.30
|
| Rate for Payer: Aetna Medicare |
$489.18
|
| Rate for Payer: BCBS Complete |
$332.35
|
| Rate for Payer: BCBS MAPPO |
$470.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,133.88
|
| Rate for Payer: BCN Commercial |
$728.13
|
| Rate for Payer: BCN Medicare Advantage |
$470.37
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cofinity Commercial |
$677.33
|
| Rate for Payer: Cofinity Commercial |
$630.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.37
|
| Rate for Payer: Mclaren Medicaid |
$316.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.89
|
| Rate for Payer: Meridian Medicaid |
$332.35
|
| Rate for Payer: Nomi Health Commercial |
$564.44
|
| Rate for Payer: PACE SWMI |
$470.37
|
| Rate for Payer: PHP Medicare Advantage |
$470.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.80
|
| Rate for Payer: Priority Health HMO/PPO |
$797.84
|
| Rate for Payer: Priority Health Medicare |
$475.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$470.37
|
| Rate for Payer: UHC Exchange |
$470.37
|
| Rate for Payer: UHC Medicare Advantage |
$470.37
|
| Rate for Payer: UHCCP Medicaid |
$316.52
|
|
|
PR CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT
|
Professional
|
Both
|
$848.00
|
|
|
Service Code
|
HCPCS 52356
|
| Min. Negotiated Rate |
$262.42 |
| Max. Negotiated Rate |
$651.90 |
| Rate for Payer: Aetna Commercial |
$528.35
|
| Rate for Payer: Aetna Medicare |
$410.06
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$394.29
|
| Rate for Payer: BCBS Trust/PPO |
$478.11
|
| Rate for Payer: BCN Commercial |
$591.79
|
| Rate for Payer: BCN Medicare Advantage |
$394.29
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cofinity Commercial |
$567.78
|
| Rate for Payer: Cofinity Commercial |
$528.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.29
|
| Rate for Payer: Mclaren Medicaid |
$262.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.00
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Nomi Health Commercial |
$473.15
|
| Rate for Payer: PACE SWMI |
$394.29
|
| Rate for Payer: PHP Medicare Advantage |
$394.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.20
|
| Rate for Payer: Priority Health HMO/PPO |
$651.90
|
| Rate for Payer: Priority Health Medicare |
$398.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$651.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.29
|
| Rate for Payer: UHC Exchange |
$394.29
|
| Rate for Payer: UHC Medicare Advantage |
$394.29
|
| Rate for Payer: UHCCP Medicaid |
$262.42
|
|
|
PR CYSTOURETHROSCOPY
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 52000
|
| Min. Negotiated Rate |
$50.91 |
| Max. Negotiated Rate |
$1,840.07 |
| Rate for Payer: Aetna Commercial |
$102.32
|
| Rate for Payer: Aetna Medicare |
$79.41
|
| Rate for Payer: BCBS Complete |
$53.46
|
| Rate for Payer: BCBS MAPPO |
$76.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.07
|
| Rate for Payer: BCN Commercial |
$352.33
|
| Rate for Payer: BCN Medicare Advantage |
$76.36
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$109.96
|
| Rate for Payer: Cofinity Commercial |
$102.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.36
|
| Rate for Payer: Mclaren Medicaid |
$50.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.18
|
| Rate for Payer: Meridian Medicaid |
$53.46
|
| Rate for Payer: Nomi Health Commercial |
$91.63
|
| Rate for Payer: PACE SWMI |
$76.36
|
| Rate for Payer: PHP Medicare Advantage |
$76.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.50
|
| Rate for Payer: Priority Health HMO/PPO |
$126.75
|
| Rate for Payer: Priority Health Medicare |
$77.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.36
|
| Rate for Payer: UHC Exchange |
$76.36
|
| Rate for Payer: UHC Medicare Advantage |
$76.36
|
| Rate for Payer: UHCCP Medicaid |
$50.91
|
|
|
PR CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER
|
Professional
|
Both
|
$705.00
|
|
|
Service Code
|
HCPCS 52287
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$1,222.49 |
| Rate for Payer: Aetna Commercial |
$216.13
|
| Rate for Payer: Aetna Medicare |
$167.74
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$161.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,222.49
|
| Rate for Payer: BCN Commercial |
$570.29
|
| Rate for Payer: BCN Medicare Advantage |
$161.29
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cofinity Commercial |
$232.26
|
| Rate for Payer: Cofinity Commercial |
$216.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.29
|
| Rate for Payer: Mclaren Medicaid |
$107.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.35
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Nomi Health Commercial |
$193.55
|
| Rate for Payer: PACE SWMI |
$161.29
|
| Rate for Payer: PHP Medicare Advantage |
$161.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.25
|
| Rate for Payer: Priority Health HMO/PPO |
$265.76
|
| Rate for Payer: Priority Health Medicare |
$162.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$265.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.29
|
| Rate for Payer: UHC Exchange |
$161.29
|
| Rate for Payer: UHC Medicare Advantage |
$161.29
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
|
|
PR CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 52282
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$1,714.86 |
| Rate for Payer: Aetna Commercial |
$428.72
|
| Rate for Payer: Aetna Medicare |
$332.74
|
| Rate for Payer: BCBS Complete |
$223.65
|
| Rate for Payer: BCBS MAPPO |
$319.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,714.86
|
| Rate for Payer: BCN Commercial |
$479.88
|
| Rate for Payer: BCN Medicare Advantage |
$319.94
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$460.71
|
| Rate for Payer: Cofinity Commercial |
$428.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.94
|
| Rate for Payer: Mclaren Medicaid |
$213.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.94
|
| Rate for Payer: Meridian Medicaid |
$223.65
|
| Rate for Payer: Nomi Health Commercial |
$383.93
|
| Rate for Payer: PACE SWMI |
$319.94
|
| Rate for Payer: PHP Medicare Advantage |
$319.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO |
$529.41
|
| Rate for Payer: Priority Health Medicare |
$323.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.94
|
| Rate for Payer: UHC Exchange |
$319.94
|
| Rate for Payer: UHC Medicare Advantage |
$319.94
|
| Rate for Payer: UHCCP Medicaid |
$213.00
|
|
