|
PR DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION
|
Professional
|
Both
|
$217.00
|
|
|
Service Code
|
HCPCS 54055
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$162.75 |
| Rate for Payer: Aetna Commercial |
$119.53
|
| Rate for Payer: Aetna Medicare |
$108.50
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCN Commercial |
$146.91
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Mclaren Medicaid |
$55.38
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$160.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.02
|
| Rate for Payer: UHC Medicaid |
$55.38
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
|
PR DSTRJ LESION PENIS SIMPLE LASER
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 54057
|
| Min. Negotiated Rate |
$58.15 |
| Max. Negotiated Rate |
$192.00 |
| Rate for Payer: Aetna Commercial |
$121.38
|
| Rate for Payer: Aetna Medicare |
$128.00
|
| Rate for Payer: BCBS Complete |
$61.06
|
| Rate for Payer: BCN Commercial |
$145.91
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Mclaren Medicaid |
$58.15
|
| Rate for Payer: Meridian Medicaid |
$61.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.95
|
| Rate for Payer: UHC Medicaid |
$58.15
|
| Rate for Payer: UHCCP Medicaid |
$58.15
|
|
|
PR DSTRJ LESION PENIS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 54060
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Aetna Commercial |
$165.73
|
| Rate for Payer: Aetna Medicare |
$189.00
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCN Commercial |
$199.69
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Mclaren Medicaid |
$78.17
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$217.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.53
|
| Rate for Payer: UHC Medicaid |
$78.17
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
|
|
PR DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 40820
|
| Min. Negotiated Rate |
$97.77 |
| Max. Negotiated Rate |
$362.25 |
| Rate for Payer: Aetna Commercial |
$221.49
|
| Rate for Payer: Aetna Medicare |
$241.50
|
| Rate for Payer: BCBS Complete |
$102.66
|
| Rate for Payer: BCN Commercial |
$247.49
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Mclaren Medicaid |
$97.77
|
| Rate for Payer: Meridian Medicaid |
$102.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$362.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$301.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.55
|
| Rate for Payer: UHC Medicaid |
$97.77
|
| Rate for Payer: UHCCP Medicaid |
$97.77
|
|
|
PR DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM
|
Professional
|
Both
|
$585.00
|
|
|
Service Code
|
HCPCS 17276
|
| Min. Negotiated Rate |
$106.93 |
| Max. Negotiated Rate |
$438.75 |
| Rate for Payer: Aetna Commercial |
$216.11
|
| Rate for Payer: Aetna Medicare |
$292.50
|
| Rate for Payer: BCBS Complete |
$112.28
|
| Rate for Payer: BCN Commercial |
$239.15
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Mclaren Medicaid |
$106.93
|
| Rate for Payer: Meridian Medicaid |
$112.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$277.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.57
|
| Rate for Payer: UHC Medicaid |
$106.93
|
| Rate for Payer: UHCCP Medicaid |
$106.93
|
|
|
PR DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR
|
Professional
|
Both
|
$1,248.00
|
|
|
Service Code
|
HCPCS 64610
|
| Min. Negotiated Rate |
$286.49 |
| Max. Negotiated Rate |
$936.00 |
| Rate for Payer: Aetna Commercial |
$624.37
|
| Rate for Payer: Aetna Medicare |
$624.00
|
| Rate for Payer: BCBS Complete |
$300.81
|
| Rate for Payer: BCN Commercial |
$726.55
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Mclaren Medicaid |
$286.49
|
| Rate for Payer: Meridian Medicaid |
$300.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$936.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$843.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$843.89
|
| Rate for Payer: UHC Medicaid |
$286.49
|
| Rate for Payer: UHCCP Medicaid |
$286.49
|
|
|
PR DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE
|
Professional
|
Both
|
$795.00
|
|
|
Service Code
|
HCPCS 64620
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$596.25 |
| Rate for Payer: Aetna Commercial |
$225.82
|
| Rate for Payer: Aetna Medicare |
$397.50
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCN Commercial |
$267.91
|
| Rate for Payer: Cash Price |
$636.00
|
| Rate for Payer: Cash Price |
$636.00
|
| Rate for Payer: Mclaren Medicaid |
$106.71
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$596.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.17
|
| Rate for Payer: UHC Medicaid |
$106.71
|
| Rate for Payer: UHCCP Medicaid |
$106.71
|
|
|
PR DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE
|
Professional
|
Both
|
$626.00
|
|
|
Service Code
|
HCPCS 64640
|
| Min. Negotiated Rate |
$71.14 |
| Max. Negotiated Rate |
$469.50 |
| Rate for Payer: Aetna Commercial |
$151.56
|
| Rate for Payer: Aetna Medicare |
$313.00
|
| Rate for Payer: BCBS Complete |
$74.70
|
| Rate for Payer: BCN Commercial |
$180.27
|
| Rate for Payer: Cash Price |
$500.80
|
| Rate for Payer: Cash Price |
$500.80
|
| Rate for Payer: Mclaren Medicaid |
$71.14
|
| Rate for Payer: Meridian Medicaid |
$74.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$469.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$209.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$209.37
|
| Rate for Payer: UHC Medicaid |
$71.14
|
| Rate for Payer: UHCCP Medicaid |
$71.14
|
|
|
PR DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
HCPCS 64632
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Aetna Commercial |
$85.44
|
| Rate for Payer: Aetna Medicare |
$97.50
|
| Rate for Payer: BCBS Complete |
$41.38
|
| Rate for Payer: BCN Commercial |
$101.59
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Mclaren Medicaid |
$39.41
|
| Rate for Payer: Meridian Medicaid |
$41.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.00
|
| Rate for Payer: UHC Medicaid |
$39.41
|
| Rate for Payer: UHCCP Medicaid |
$39.41
|
|
|
PR DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS
|
Professional
|
Both
|
$707.00
|
|
|
Service Code
|
HCPCS 64680
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$530.25 |
| Rate for Payer: Aetna Commercial |
$206.19
|
| Rate for Payer: Aetna Medicare |
$353.50
|
| Rate for Payer: BCBS Complete |
$98.19
|
| Rate for Payer: BCN Commercial |
$241.52
|
| Rate for Payer: Cash Price |
$565.60
|
| Rate for Payer: Cash Price |
$565.60
|
| Rate for Payer: Mclaren Medicaid |
$93.51
|
| Rate for Payer: Meridian Medicaid |
$98.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$530.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$280.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$280.52
|
| Rate for Payer: UHC Medicaid |
$93.51
|
| Rate for Payer: UHCCP Medicaid |
$93.51
|
|
|
PR DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS
|
Professional
|
Both
|
$940.00
|
|
|
Service Code
|
HCPCS 64681
|
| Min. Negotiated Rate |
$123.11 |
| Max. Negotiated Rate |
$705.00 |
| Rate for Payer: Aetna Commercial |
$288.28
|
| Rate for Payer: Aetna Medicare |
$470.00
|
| Rate for Payer: BCBS Complete |
$129.27
|
| Rate for Payer: BCN Commercial |
$331.16
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Mclaren Medicaid |
$123.11
|
| Rate for Payer: Meridian Medicaid |
$129.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$384.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.63
|
| Rate for Payer: UHC Medicaid |
$123.11
|
| Rate for Payer: UHCCP Medicaid |
$123.11
|
|
|
PR DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH
|
Professional
|
Both
|
$926.00
|
|
|
Service Code
|
HCPCS 64600
|
| Min. Negotiated Rate |
$144.84 |
| Max. Negotiated Rate |
$694.50 |
| Rate for Payer: Aetna Commercial |
$292.11
|
| Rate for Payer: Aetna Medicare |
$463.00
|
| Rate for Payer: BCBS Complete |
$152.08
|
| Rate for Payer: BCN Commercial |
$363.03
|
| Rate for Payer: Cash Price |
$740.80
|
| Rate for Payer: Cash Price |
$740.80
|
| Rate for Payer: Mclaren Medicaid |
$144.84
|
| Rate for Payer: Meridian Medicaid |
$152.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$421.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.66
|
| Rate for Payer: UHC Medicaid |
$144.84
|
| Rate for Payer: UHCCP Medicaid |
$144.84
|
|
|
PR DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 64634
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCN Commercial |
$99.60
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Mclaren Medicaid |
$36.85
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$115.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.67
|
| Rate for Payer: UHC Medicaid |
$36.85
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
|
|
PR DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL
|
Professional
|
Both
|
$346.00
|
|
|
Service Code
|
HCPCS 64636
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$259.50 |
| Rate for Payer: Aetna Commercial |
$76.93
|
| Rate for Payer: Aetna Medicare |
$173.00
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCN Commercial |
$87.65
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Mclaren Medicaid |
$32.38
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.80
|
| Rate for Payer: UHC Medicaid |
$32.38
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
|
|
PR DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA
|
Professional
|
Both
|
$641.00
|
|
|
Service Code
|
HCPCS 64633
|
| Min. Negotiated Rate |
$110.12 |
| Max. Negotiated Rate |
$480.75 |
| Rate for Payer: Aetna Commercial |
$287.73
|
| Rate for Payer: Aetna Medicare |
$320.50
|
| Rate for Payer: BCBS Complete |
$115.63
|
| Rate for Payer: BCN Commercial |
$287.33
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Mclaren Medicaid |
$110.12
|
| Rate for Payer: Meridian Medicaid |
$115.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$333.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.74
|
| Rate for Payer: UHC Medicaid |
$110.12
|
| Rate for Payer: UHCCP Medicaid |
$110.12
|
|
|
PR DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL
|
Professional
|
Both
|
$633.00
|
|
|
Service Code
|
HCPCS 64635
|
| Min. Negotiated Rate |
$110.33 |
| Max. Negotiated Rate |
$474.75 |
| Rate for Payer: Aetna Commercial |
$283.74
|
| Rate for Payer: Aetna Medicare |
$316.50
|
| Rate for Payer: BCBS Complete |
$115.85
|
| Rate for Payer: BCN Commercial |
$287.33
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Mclaren Medicaid |
$110.33
|
| Rate for Payer: Meridian Medicaid |
$115.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$474.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$333.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.74
|
| Rate for Payer: UHC Medicaid |
$110.33
|
| Rate for Payer: UHCCP Medicaid |
$110.33
|
|
|
PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 90723
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$103.62 |
| Rate for Payer: Aetna Commercial |
$95.50
|
| Rate for Payer: Aetna Medicare |
$63.00
|
| Rate for Payer: BCBS Trust/PPO |
$103.62
|
| Rate for Payer: BCN Commercial |
$101.34
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
|
|
PR DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 90697
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$167.36 |
| Rate for Payer: Aetna Commercial |
$154.01
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: BCBS Trust/PPO |
$167.36
|
| Rate for Payer: BCN Commercial |
$153.46
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.00
|
|
|
PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS 90698
|
| Min. Negotiated Rate |
$56.50 |
| Max. Negotiated Rate |
$130.53 |
| Rate for Payer: Aetna Commercial |
$118.20
|
| Rate for Payer: Aetna Medicare |
$56.50
|
| Rate for Payer: BCBS Trust/PPO |
$130.53
|
| Rate for Payer: BCN Commercial |
$117.52
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.75
|
|
|
PR DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 90696
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna Commercial |
$62.89
|
| Rate for Payer: Aetna Medicare |
$35.00
|
| Rate for Payer: BCBS Trust/PPO |
$62.82
|
| Rate for Payer: BCN Commercial |
$63.04
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.50
|
|
|
PR DTP/HIB VACCINE,IM
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 90720
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Medicare |
$42.00
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
|
|
PR DT VACCINE YOUNGER THAN 7 YRS FOR IM USE
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 90702
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$79.01 |
| Rate for Payer: Aetna Commercial |
$67.16
|
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Trust/PPO |
$66.09
|
| Rate for Payer: BCN Commercial |
$79.01
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
|
|
PR DUODENAL INTUBAT W/IMAG GUIDED SINGLE SPECIMEN
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 43756
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$67.03
|
| Rate for Payer: Aetna Medicare |
$250.00
|
| Rate for Payer: BCBS Complete |
$31.53
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Mclaren Medicaid |
$30.03
|
| Rate for Payer: Meridian Medicaid |
$31.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.61
|
| Rate for Payer: UHC Medicaid |
$30.03
|
| Rate for Payer: UHCCP Medicaid |
$30.03
|
|
|
PR DUODENOTOMY EXPLORATION/BX/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$3,024.00
|
|
|
Service Code
|
HCPCS 44010
|
| Min. Negotiated Rate |
$499.06 |
| Max. Negotiated Rate |
$2,268.00 |
| Rate for Payer: Aetna Commercial |
$1,155.16
|
| Rate for Payer: Aetna Medicare |
$1,512.00
|
| Rate for Payer: BCBS Complete |
$524.01
|
| Rate for Payer: BCN Commercial |
$1,266.36
|
| Rate for Payer: Cash Price |
$2,419.20
|
| Rate for Payer: Cash Price |
$2,419.20
|
| Rate for Payer: Mclaren Medicaid |
$499.06
|
| Rate for Payer: Meridian Medicaid |
$524.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,268.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,542.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,542.98
|
| Rate for Payer: UHC Medicaid |
$499.06
|
| Rate for Payer: UHCCP Medicaid |
$499.06
|
|
|
PR DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ
|
Professional
|
Both
|
$6,469.00
|
|
|
Service Code
|
HCPCS 48547
|
| Min. Negotiated Rate |
$1,061.81 |
| Max. Negotiated Rate |
$4,851.75 |
| Rate for Payer: Aetna Commercial |
$2,429.46
|
| Rate for Payer: Aetna Medicare |
$3,234.50
|
| Rate for Payer: BCBS Complete |
$1,114.90
|
| Rate for Payer: BCN Commercial |
$2,685.61
|
| Rate for Payer: Cash Price |
$5,175.20
|
| Rate for Payer: Cash Price |
$5,175.20
|
| Rate for Payer: Mclaren Medicaid |
$1,061.81
|
| Rate for Payer: Meridian Medicaid |
$1,114.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,851.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,061.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,272.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,272.25
|
| Rate for Payer: UHC Medicaid |
$1,061.81
|
| Rate for Payer: UHCCP Medicaid |
$1,061.81
|
|
