|
PR PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN
|
Professional
|
Both
|
$1,932.00
|
|
|
Service Code
|
HCPCS 44300
|
| Min. Negotiated Rate |
$538.89 |
| Max. Negotiated Rate |
$3,186.71 |
| Rate for Payer: Aetna Commercial |
$1,120.35
|
| Rate for Payer: Aetna Medicare |
$869.52
|
| Rate for Payer: BCBS Complete |
$565.83
|
| Rate for Payer: BCBS MAPPO |
$836.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,186.71
|
| Rate for Payer: BCN Commercial |
$1,228.54
|
| Rate for Payer: BCN Medicare Advantage |
$836.08
|
| Rate for Payer: Cash Price |
$1,545.60
|
| Rate for Payer: Cash Price |
$1,545.60
|
| Rate for Payer: Cofinity Commercial |
$1,203.96
|
| Rate for Payer: Cofinity Commercial |
$1,120.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$836.08
|
| Rate for Payer: Mclaren Medicaid |
$538.89
|
| Rate for Payer: Meridian Medicaid |
$565.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$877.88
|
| Rate for Payer: PACE SWMI |
$836.08
|
| Rate for Payer: PHP Medicare Advantage |
$836.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,352.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,478.16
|
| Rate for Payer: Priority Health Medicare |
$836.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,478.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$836.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$836.08
|
| Rate for Payer: UHC Medicare Advantage |
$861.16
|
|
|
PR PLACEMENT NEEDLE INTRAOSSEOUS INFUSION
|
Professional
|
Both
|
$554.00
|
|
|
Service Code
|
HCPCS 36680
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$835.77 |
| Rate for Payer: Aetna Commercial |
$79.30
|
| Rate for Payer: Aetna Medicare |
$61.55
|
| Rate for Payer: BCBS Complete |
$39.58
|
| Rate for Payer: BCBS MAPPO |
$59.18
|
| Rate for Payer: BCBS Trust/PPO |
$835.77
|
| Rate for Payer: BCN Commercial |
$86.01
|
| Rate for Payer: BCN Medicare Advantage |
$59.18
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cofinity Commercial |
$79.30
|
| Rate for Payer: Cofinity Commercial |
$85.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.18
|
| Rate for Payer: Mclaren Medicaid |
$37.70
|
| Rate for Payer: Meridian Medicaid |
$39.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.14
|
| Rate for Payer: PACE SWMI |
$59.18
|
| Rate for Payer: PHP Medicare Advantage |
$59.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.62
|
| Rate for Payer: Priority Health Medicare |
$59.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.18
|
| Rate for Payer: UHC Medicare Advantage |
$60.96
|
|
|
PR PLACEMENT SETON
|
Professional
|
Both
|
$382.00
|
|
|
Service Code
|
HCPCS 46020
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$1,247.84 |
| Rate for Payer: Aetna Commercial |
$153.68
|
| Rate for Payer: Aetna Medicare |
$119.28
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$114.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.84
|
| Rate for Payer: BCN Commercial |
$169.57
|
| Rate for Payer: BCN Medicare Advantage |
$114.69
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cofinity Commercial |
$165.15
|
| Rate for Payer: Cofinity Commercial |
$153.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.69
|
| Rate for Payer: Mclaren Medicaid |
$74.55
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.42
|
| Rate for Payer: PACE SWMI |
$114.69
|
| Rate for Payer: PHP Medicare Advantage |
$114.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.03
|
| Rate for Payer: Priority Health Medicare |
$114.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.69
|
| Rate for Payer: UHC Medicare Advantage |
$118.13
|
|
|
PR PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR
|
Professional
|
Both
|
$668.00
|
|
|
Service Code
|
HCPCS 34709
|
| Min. Negotiated Rate |
$200.01 |
| Max. Negotiated Rate |
$2,173.43 |
| Rate for Payer: Aetna Commercial |
$426.25
|
| Rate for Payer: Aetna Medicare |
$330.82
|
| Rate for Payer: BCBS Complete |
$210.01
|
| Rate for Payer: BCBS MAPPO |
$318.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,173.43
|
| Rate for Payer: BCN Commercial |
$458.86
|
| Rate for Payer: BCN Medicare Advantage |
$318.10
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Cofinity Commercial |
$458.06
|
| Rate for Payer: Cofinity Commercial |
$426.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.10
|
| Rate for Payer: Mclaren Medicaid |
$200.01
|
| Rate for Payer: Meridian Medicaid |
$210.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$334.00
|
| Rate for Payer: PACE SWMI |
$318.10
|
| Rate for Payer: PHP Medicare Advantage |
$318.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$499.51
|
| Rate for Payer: Priority Health Medicare |
$318.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$499.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.10
|
| Rate for Payer: UHC Medicare Advantage |
$327.64
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,1ST ACCESS W/ RAD EVAL
|
Professional
|
Both
|
$1,480.00
|
|
|
Service Code
|
HCPCS 36147
|
| Min. Negotiated Rate |
$592.00 |
| Max. Negotiated Rate |
$1,036.00 |
| Rate for Payer: BCBS Complete |
$592.00
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,036.00
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,ADDL ACCESS FOR THERAPY
|
Professional
|
Both
|
$660.00
|
|
|
Service Code
|
HCPCS 36148
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$462.00 |
| Rate for Payer: BCBS Complete |
$264.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.00
|
|
|
PR PLASTIC OPERATION PENIS INJURY
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 54440
|
| Min. Negotiated Rate |
$711.74 |
| Max. Negotiated Rate |
$2,964.74 |
| Rate for Payer: Aetna Commercial |
$711.74
|
| Rate for Payer: BCBS Complete |
$777.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,537.35
|
| Rate for Payer: BCN Commercial |
$2,964.74
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Mclaren Medicaid |
$740.06
|
| Rate for Payer: Meridian Medicaid |
$777.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,360.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$894.29
|
|
|
PR PLASTIC REPAIR INTROITUS
|
Professional
|
Both
|
$881.00
|
|
|
Service Code
|
HCPCS 56800
|
| Min. Negotiated Rate |
$163.16 |
| Max. Negotiated Rate |
$1,759.77 |
| Rate for Payer: Aetna Commercial |
$335.98
|
| Rate for Payer: Aetna Medicare |
$260.76
|
| Rate for Payer: BCBS Complete |
$171.32
|
| Rate for Payer: BCBS MAPPO |
$250.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,759.77
|
| Rate for Payer: BCN Commercial |
$372.37
|
| Rate for Payer: BCN Medicare Advantage |
$250.73
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cofinity Commercial |
$361.05
|
| Rate for Payer: Cofinity Commercial |
$335.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.73
|
| Rate for Payer: Mclaren Medicaid |
$163.16
|
| Rate for Payer: Meridian Medicaid |
$171.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$263.27
|
| Rate for Payer: PACE SWMI |
$250.73
|
| Rate for Payer: PHP Medicare Advantage |
$250.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$616.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$360.75
|
| Rate for Payer: Priority Health Medicare |
$250.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.73
|
| Rate for Payer: UHC Medicare Advantage |
$258.25
|
|
|
PR PLASTIC REPAIR URETHROCELE
|
Professional
|
Both
|
$793.00
|
|
|
Service Code
|
HCPCS 57230
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$618.18 |
| Rate for Payer: Aetna Commercial |
$556.70
|
| Rate for Payer: Aetna Medicare |
$432.07
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$415.45
|
| Rate for Payer: BCBS Trust/PPO |
$286.34
|
| Rate for Payer: BCN Commercial |
$618.18
|
| Rate for Payer: BCN Medicare Advantage |
$415.45
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cofinity Commercial |
$556.70
|
| Rate for Payer: Cofinity Commercial |
$598.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.45
|
| Rate for Payer: Mclaren Medicaid |
$270.51
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$436.22
|
| Rate for Payer: PACE SWMI |
$415.45
|
| Rate for Payer: PHP Medicare Advantage |
$415.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$598.88
|
| Rate for Payer: Priority Health Medicare |
$415.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$598.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$415.45
|
| Rate for Payer: UHC Medicare Advantage |
$427.91
|
|
|
PR PLASTIC RPR PENIS CORRECT ANGULATION
|
Professional
|
Both
|
$3,726.00
|
|
|
Service Code
|
HCPCS 54360
|
| Min. Negotiated Rate |
$459.23 |
| Max. Negotiated Rate |
$2,608.20 |
| Rate for Payer: Aetna Commercial |
$944.24
|
| Rate for Payer: Aetna Medicare |
$732.85
|
| Rate for Payer: BCBS Complete |
$482.19
|
| Rate for Payer: BCBS MAPPO |
$704.66
|
| Rate for Payer: BCBS Trust/PPO |
$602.79
|
| Rate for Payer: BCN Commercial |
$1,040.88
|
| Rate for Payer: BCN Medicare Advantage |
$704.66
|
| Rate for Payer: Cash Price |
$2,980.80
|
| Rate for Payer: Cash Price |
$2,980.80
|
| Rate for Payer: Cofinity Commercial |
$944.24
|
| Rate for Payer: Cofinity Commercial |
$1,014.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.66
|
| Rate for Payer: Mclaren Medicaid |
$459.23
|
| Rate for Payer: Meridian Medicaid |
$482.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$739.89
|
| Rate for Payer: PACE SWMI |
$704.66
|
| Rate for Payer: PHP Medicare Advantage |
$704.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$459.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,608.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.97
|
| Rate for Payer: Priority Health Medicare |
$704.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$704.66
|
| Rate for Payer: UHC Medicare Advantage |
$725.80
|
|
|
PR PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH
|
Professional
|
Both
|
$1,075.00
|
|
|
Service Code
|
HCPCS 57220
|
| Min. Negotiated Rate |
$223.44 |
| Max. Negotiated Rate |
$2,103.16 |
| Rate for Payer: Aetna Commercial |
$456.27
|
| Rate for Payer: Aetna Medicare |
$354.12
|
| Rate for Payer: BCBS Complete |
$234.61
|
| Rate for Payer: BCBS MAPPO |
$340.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,103.16
|
| Rate for Payer: BCN Commercial |
$509.20
|
| Rate for Payer: BCN Medicare Advantage |
$340.50
|
| Rate for Payer: Cash Price |
$860.00
|
| Rate for Payer: Cash Price |
$860.00
|
| Rate for Payer: Cofinity Commercial |
$490.32
|
| Rate for Payer: Cofinity Commercial |
$456.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.50
|
| Rate for Payer: Mclaren Medicaid |
$223.44
|
| Rate for Payer: Meridian Medicaid |
$234.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$357.52
|
| Rate for Payer: PACE SWMI |
$340.50
|
| Rate for Payer: PHP Medicare Advantage |
$340.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$752.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$493.30
|
| Rate for Payer: Priority Health Medicare |
$340.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$340.50
|
| Rate for Payer: UHC Medicare Advantage |
$350.72
|
|
|
PR PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 94726
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$369.28 |
| Rate for Payer: Aetna Commercial |
$68.29
|
| Rate for Payer: Aetna Commercial |
$68.29
|
| Rate for Payer: Aetna Medicare |
$53.00
|
| Rate for Payer: Aetna Medicare |
$53.00
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS MAPPO |
$50.96
|
| Rate for Payer: BCBS MAPPO |
$50.96
|
| Rate for Payer: BCBS Trust/PPO |
$369.28
|
| Rate for Payer: BCBS Trust/PPO |
$369.28
|
| Rate for Payer: BCN Commercial |
$79.16
|
| Rate for Payer: BCN Commercial |
$79.16
|
| Rate for Payer: BCN Medicare Advantage |
$50.96
|
| Rate for Payer: BCN Medicare Advantage |
$50.96
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$68.29
|
| Rate for Payer: Cofinity Commercial |
$73.38
|
| Rate for Payer: Cofinity Commercial |
$73.38
|
| Rate for Payer: Cofinity Commercial |
$68.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.51
|
| Rate for Payer: PACE SWMI |
$50.96
|
| Rate for Payer: PACE SWMI |
$50.96
|
| Rate for Payer: PHP Medicare Advantage |
$50.96
|
| Rate for Payer: PHP Medicare Advantage |
$50.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.76
|
| Rate for Payer: Priority Health Medicare |
$50.96
|
| Rate for Payer: Priority Health Medicare |
$50.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.96
|
| Rate for Payer: UHC Medicare Advantage |
$52.49
|
| Rate for Payer: UHC Medicare Advantage |
$52.49
|
|
|
PR PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX
|
Professional
|
Both
|
$2,134.00
|
|
|
Service Code
|
HCPCS 32215
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$1,493.80 |
| Rate for Payer: Aetna Commercial |
$1,057.58
|
| Rate for Payer: Aetna Medicare |
$820.81
|
| Rate for Payer: BCBS Complete |
$534.30
|
| Rate for Payer: BCBS MAPPO |
$789.24
|
| Rate for Payer: BCBS Trust/PPO |
$509.28
|
| Rate for Payer: BCN Commercial |
$1,159.15
|
| Rate for Payer: BCN Medicare Advantage |
$789.24
|
| Rate for Payer: Cash Price |
$1,707.20
|
| Rate for Payer: Cash Price |
$1,707.20
|
| Rate for Payer: Cofinity Commercial |
$1,136.51
|
| Rate for Payer: Cofinity Commercial |
$1,057.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$789.24
|
| Rate for Payer: Mclaren Medicaid |
$508.86
|
| Rate for Payer: Meridian Medicaid |
$534.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$828.70
|
| Rate for Payer: PACE SWMI |
$789.24
|
| Rate for Payer: PHP Medicare Advantage |
$789.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,098.34
|
| Rate for Payer: Priority Health Medicare |
$789.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,098.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$789.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$789.24
|
| Rate for Payer: UHC Medicare Advantage |
$812.92
|
|
|
PR PLEURECTOMY PARIETAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,891.00
|
|
|
Service Code
|
HCPCS 32310
|
| Min. Negotiated Rate |
$409.96 |
| Max. Negotiated Rate |
$2,023.70 |
| Rate for Payer: Aetna Commercial |
$1,210.84
|
| Rate for Payer: Aetna Medicare |
$939.75
|
| Rate for Payer: BCBS Complete |
$610.34
|
| Rate for Payer: BCBS MAPPO |
$903.61
|
| Rate for Payer: BCBS Trust/PPO |
$409.96
|
| Rate for Payer: BCN Commercial |
$1,325.29
|
| Rate for Payer: BCN Medicare Advantage |
$903.61
|
| Rate for Payer: Cash Price |
$2,312.80
|
| Rate for Payer: Cash Price |
$2,312.80
|
| Rate for Payer: Cofinity Commercial |
$1,301.20
|
| Rate for Payer: Cofinity Commercial |
$1,210.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.61
|
| Rate for Payer: Mclaren Medicaid |
$581.28
|
| Rate for Payer: Meridian Medicaid |
$610.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$948.79
|
| Rate for Payer: PACE SWMI |
$903.61
|
| Rate for Payer: PHP Medicare Advantage |
$903.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,023.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,255.78
|
| Rate for Payer: Priority Health Medicare |
$903.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,255.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$903.61
|
| Rate for Payer: UHC Medicare Advantage |
$930.72
|
|
|
PR PL GLYCOLIC 35/70
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 00067
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
|
|
PR PL ILLUMINIZE
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 00069
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
|
|
PR PL JESSNERS
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 00068
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
|
|
PR PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST
|
Professional
|
Both
|
$9,986.00
|
|
|
Service Code
|
HCPCS 19296
|
| Min. Negotiated Rate |
$133.76 |
| Max. Negotiated Rate |
$6,990.20 |
| Rate for Payer: Aetna Commercial |
$279.81
|
| Rate for Payer: Aetna Medicare |
$217.16
|
| Rate for Payer: BCBS Complete |
$140.45
|
| Rate for Payer: BCBS MAPPO |
$208.81
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$5,484.92
|
| Rate for Payer: BCN Medicare Advantage |
$208.81
|
| Rate for Payer: Cash Price |
$7,988.80
|
| Rate for Payer: Cash Price |
$7,988.80
|
| Rate for Payer: Cofinity Commercial |
$300.69
|
| Rate for Payer: Cofinity Commercial |
$279.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.81
|
| Rate for Payer: Mclaren Medicaid |
$133.76
|
| Rate for Payer: Meridian Medicaid |
$140.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$219.25
|
| Rate for Payer: PACE SWMI |
$208.81
|
| Rate for Payer: PHP Medicare Advantage |
$208.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,990.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.91
|
| Rate for Payer: Priority Health Medicare |
$208.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$208.81
|
| Rate for Payer: UHC Medicare Advantage |
$215.07
|
|
|
PR PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR
|
Professional
|
Both
|
$1,195.00
|
|
|
Service Code
|
HCPCS 34813
|
| Min. Negotiated Rate |
$145.91 |
| Max. Negotiated Rate |
$836.50 |
| Rate for Payer: Aetna Commercial |
$311.68
|
| Rate for Payer: Aetna Medicare |
$241.90
|
| Rate for Payer: BCBS Complete |
$153.21
|
| Rate for Payer: BCBS MAPPO |
$232.60
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$335.23
|
| Rate for Payer: BCN Medicare Advantage |
$232.60
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$334.94
|
| Rate for Payer: Cofinity Commercial |
$311.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.60
|
| Rate for Payer: Mclaren Medicaid |
$145.91
|
| Rate for Payer: Meridian Medicaid |
$153.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$244.23
|
| Rate for Payer: PACE SWMI |
$232.60
|
| Rate for Payer: PHP Medicare Advantage |
$232.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$836.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$364.93
|
| Rate for Payer: Priority Health Medicare |
$232.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$364.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.60
|
| Rate for Payer: UHC Medicare Advantage |
$239.58
|
|
|
PR PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 55876
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$2,499.92 |
| Rate for Payer: Aetna Commercial |
$132.51
|
| Rate for Payer: Aetna Medicare |
$102.85
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$98.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,499.92
|
| Rate for Payer: BCN Commercial |
$220.88
|
| Rate for Payer: BCN Medicare Advantage |
$98.89
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$142.40
|
| Rate for Payer: Cofinity Commercial |
$132.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.89
|
| Rate for Payer: Mclaren Medicaid |
$64.97
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$103.83
|
| Rate for Payer: PACE SWMI |
$98.89
|
| Rate for Payer: PHP Medicare Advantage |
$98.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.10
|
| Rate for Payer: Priority Health Medicare |
$98.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.89
|
| Rate for Payer: UHC Medicare Advantage |
$101.86
|
|
|
PR PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I
|
Professional
|
Both
|
$1,584.00
|
|
|
Service Code
|
HCPCS 50432
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$2,416.97 |
| Rate for Payer: Aetna Commercial |
$266.54
|
| Rate for Payer: Aetna Medicare |
$206.87
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS MAPPO |
$198.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,416.97
|
| Rate for Payer: BCN Commercial |
$1,340.94
|
| Rate for Payer: BCN Medicare Advantage |
$198.91
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cofinity Commercial |
$286.43
|
| Rate for Payer: Cofinity Commercial |
$266.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.91
|
| Rate for Payer: Mclaren Medicaid |
$126.95
|
| Rate for Payer: Meridian Medicaid |
$133.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$208.86
|
| Rate for Payer: PACE SWMI |
$198.91
|
| Rate for Payer: PHP Medicare Advantage |
$198.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,108.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.14
|
| Rate for Payer: Priority Health Medicare |
$198.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$323.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.91
|
| Rate for Payer: UHC Medicare Advantage |
$204.88
|
|
|
PR PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN
|
Professional
|
Both
|
$2,233.00
|
|
|
Service Code
|
HCPCS 33883
|
| Min. Negotiated Rate |
$693.95 |
| Max. Negotiated Rate |
$1,726.74 |
| Rate for Payer: Aetna Commercial |
$1,464.51
|
| Rate for Payer: Aetna Medicare |
$1,136.64
|
| Rate for Payer: BCBS Complete |
$728.65
|
| Rate for Payer: BCBS MAPPO |
$1,092.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.39
|
| Rate for Payer: BCN Commercial |
$1,586.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,092.92
|
| Rate for Payer: Cash Price |
$1,786.40
|
| Rate for Payer: Cash Price |
$1,786.40
|
| Rate for Payer: Cofinity Commercial |
$1,573.80
|
| Rate for Payer: Cofinity Commercial |
$1,464.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,092.92
|
| Rate for Payer: Mclaren Medicaid |
$693.95
|
| Rate for Payer: Meridian Medicaid |
$728.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,147.57
|
| Rate for Payer: PACE SWMI |
$1,092.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,092.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$693.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,563.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,726.74
|
| Rate for Payer: Priority Health Medicare |
$1,092.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,726.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,092.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,092.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,125.71
|
|
|
PR PLMT PROX XTN PROSTH EVASC RPR DTA EA PROX XTN
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
HCPCS 33884
|
| Min. Negotiated Rate |
$245.38 |
| Max. Negotiated Rate |
$1,597.58 |
| Rate for Payer: Aetna Commercial |
$522.95
|
| Rate for Payer: Aetna Medicare |
$405.87
|
| Rate for Payer: BCBS Complete |
$257.65
|
| Rate for Payer: BCBS MAPPO |
$390.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,597.58
|
| Rate for Payer: BCN Commercial |
$561.00
|
| Rate for Payer: BCN Medicare Advantage |
$390.26
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cofinity Commercial |
$522.95
|
| Rate for Payer: Cofinity Commercial |
$561.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.26
|
| Rate for Payer: Mclaren Medicaid |
$245.38
|
| Rate for Payer: Meridian Medicaid |
$257.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$409.77
|
| Rate for Payer: PACE SWMI |
$390.26
|
| Rate for Payer: PHP Medicare Advantage |
$390.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$602.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.70
|
| Rate for Payer: Priority Health Medicare |
$390.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$610.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.26
|
| Rate for Payer: UHC Medicare Advantage |
$401.97
|
|
|
PR PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT
|
Professional
|
Both
|
$552.00
|
|
|
Service Code
|
HCPCS 50693
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$3,785.27 |
| Rate for Payer: Aetna Commercial |
$264.15
|
| Rate for Payer: Aetna Medicare |
$205.02
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$197.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,785.27
|
| Rate for Payer: BCN Commercial |
$1,468.96
|
| Rate for Payer: BCN Medicare Advantage |
$197.13
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cofinity Commercial |
$264.15
|
| Rate for Payer: Cofinity Commercial |
$283.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.13
|
| Rate for Payer: Mclaren Medicaid |
$126.31
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.99
|
| Rate for Payer: PACE SWMI |
$197.13
|
| Rate for Payer: PHP Medicare Advantage |
$197.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.43
|
| Rate for Payer: Priority Health Medicare |
$197.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.13
|
| Rate for Payer: UHC Medicare Advantage |
$203.04
|
|
|
PR PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT
|
Professional
|
Both
|
$434.00
|
|
|
Service Code
|
HCPCS 35685
|
| Min. Negotiated Rate |
$122.90 |
| Max. Negotiated Rate |
$2,230.82 |
| Rate for Payer: Aetna Commercial |
$261.94
|
| Rate for Payer: Aetna Medicare |
$203.30
|
| Rate for Payer: BCBS Complete |
$129.04
|
| Rate for Payer: BCBS MAPPO |
$195.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,230.82
|
| Rate for Payer: BCN Commercial |
$281.48
|
| Rate for Payer: BCN Medicare Advantage |
$195.48
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cofinity Commercial |
$281.49
|
| Rate for Payer: Cofinity Commercial |
$261.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.48
|
| Rate for Payer: Mclaren Medicaid |
$122.90
|
| Rate for Payer: Meridian Medicaid |
$129.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$205.25
|
| Rate for Payer: PACE SWMI |
$195.48
|
| Rate for Payer: PHP Medicare Advantage |
$195.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.41
|
| Rate for Payer: Priority Health Medicare |
$195.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.48
|
| Rate for Payer: UHC Medicare Advantage |
$201.34
|
|
