|
PR EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F
|
Professional
|
Both
|
$2,731.00
|
|
|
Service Code
|
HCPCS 26390
|
| Min. Negotiated Rate |
$542.94 |
| Max. Negotiated Rate |
$2,048.25 |
| Rate for Payer: Aetna Commercial |
$1,166.48
|
| Rate for Payer: Aetna Medicare |
$1,365.50
|
| Rate for Payer: BCBS Complete |
$570.09
|
| Rate for Payer: BCN Commercial |
$1,322.64
|
| Rate for Payer: Cash Price |
$2,184.80
|
| Rate for Payer: Cash Price |
$2,184.80
|
| Rate for Payer: Mclaren Medicaid |
$542.94
|
| Rate for Payer: Meridian Medicaid |
$570.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,048.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,413.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,413.86
|
| Rate for Payer: UHC Medicaid |
$542.94
|
| Rate for Payer: UHCCP Medicaid |
$542.94
|
|
|
PR EXC FRENUM LABIAL/BUCCAL
|
Professional
|
Both
|
$525.00
|
|
|
Service Code
|
HCPCS 40819
|
| Min. Negotiated Rate |
$120.35 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna Commercial |
$264.81
|
| Rate for Payer: Aetna Medicare |
$262.50
|
| Rate for Payer: BCBS Complete |
$126.37
|
| Rate for Payer: BCN Commercial |
$305.26
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Mclaren Medicaid |
$120.35
|
| Rate for Payer: Meridian Medicaid |
$126.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$371.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$371.93
|
| Rate for Payer: UHC Medicaid |
$120.35
|
| Rate for Payer: UHCCP Medicaid |
$120.35
|
|
|
PR EXC/FULGURATION URETHRAL CARUNCLE
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 53265
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$318.00 |
| Rate for Payer: Aetna Commercial |
$241.82
|
| Rate for Payer: Aetna Medicare |
$212.00
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCN Commercial |
$285.34
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Mclaren Medicaid |
$108.63
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$310.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.84
|
| Rate for Payer: UHC Medicaid |
$108.63
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
|
|
PR EXC/FULGURATION URETHRAL POLYP DSTL URETHRA
|
Professional
|
Both
|
$283.00
|
|
|
Service Code
|
HCPCS 53260
|
| Min. Negotiated Rate |
$105.65 |
| Max. Negotiated Rate |
$297.81 |
| Rate for Payer: Aetna Commercial |
$232.51
|
| Rate for Payer: Aetna Medicare |
$141.50
|
| Rate for Payer: BCBS Complete |
$110.93
|
| Rate for Payer: BCN Commercial |
$273.39
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Mclaren Medicaid |
$105.65
|
| Rate for Payer: Meridian Medicaid |
$110.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$297.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$297.81
|
| Rate for Payer: UHC Medicaid |
$105.65
|
| Rate for Payer: UHCCP Medicaid |
$105.65
|
|
|
PR EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 50435
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna Commercial |
$126.00
|
| Rate for Payer: Aetna Medicare |
$656.00
|
| Rate for Payer: BCBS Complete |
$58.82
|
| Rate for Payer: BCN Commercial |
$146.40
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Mclaren Medicaid |
$56.02
|
| Rate for Payer: Meridian Medicaid |
$58.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$159.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$159.49
|
| Rate for Payer: UHC Medicaid |
$56.02
|
| Rate for Payer: UHCCP Medicaid |
$56.02
|
|
|
PR EXCHNG ABSC/CST DRG CATH RAD GID SPX
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 49423
|
| Min. Negotiated Rate |
$38.77 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna Commercial |
$94.51
|
| Rate for Payer: Aetna Medicare |
$656.00
|
| Rate for Payer: BCBS Complete |
$40.71
|
| Rate for Payer: BCN Commercial |
$103.08
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Mclaren Medicaid |
$38.77
|
| Rate for Payer: Meridian Medicaid |
$40.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$125.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.60
|
| Rate for Payer: UHC Medicaid |
$38.77
|
| Rate for Payer: UHCCP Medicaid |
$38.77
|
|
|
PR EXC HYDROCELE SPRMATIC CORD UNI SPX
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 55500
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$643.90 |
| Rate for Payer: Aetna Commercial |
$504.41
|
| Rate for Payer: Aetna Medicare |
$373.50
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCN Commercial |
$591.11
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Mclaren Medicaid |
$234.51
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$560.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$643.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$643.90
|
| Rate for Payer: UHC Medicaid |
$234.51
|
| Rate for Payer: UHCCP Medicaid |
$234.51
|
|
|
PR EXC ILEOANAL RSVR W/ILEOSTOMY
|
Professional
|
Both
|
$3,352.00
|
|
|
Service Code
|
HCPCS 45136
|
| Min. Negotiated Rate |
$1,042.64 |
| Max. Negotiated Rate |
$3,224.30 |
| Rate for Payer: Aetna Commercial |
$2,383.65
|
| Rate for Payer: Aetna Medicare |
$1,676.00
|
| Rate for Payer: BCBS Complete |
$1,094.77
|
| Rate for Payer: BCN Commercial |
$2,646.27
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Mclaren Medicaid |
$1,042.64
|
| Rate for Payer: Meridian Medicaid |
$1,094.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,514.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,042.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,224.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,224.30
|
| Rate for Payer: UHC Medicaid |
$1,042.64
|
| Rate for Payer: UHCCP Medicaid |
$1,042.64
|
|
|
PR EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP
|
Professional
|
Both
|
$4,524.00
|
|
|
Service Code
|
HCPCS 33120
|
| Min. Negotiated Rate |
$1,244.56 |
| Max. Negotiated Rate |
$3,393.00 |
| Rate for Payer: Aetna Commercial |
$2,813.37
|
| Rate for Payer: Aetna Medicare |
$2,262.00
|
| Rate for Payer: BCBS Complete |
$1,306.79
|
| Rate for Payer: BCN Commercial |
$3,072.05
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Mclaren Medicaid |
$1,244.56
|
| Rate for Payer: Meridian Medicaid |
$1,306.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,393.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,244.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,303.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,303.60
|
| Rate for Payer: UHC Medicaid |
$1,244.56
|
| Rate for Payer: UHCCP Medicaid |
$1,244.56
|
|
|
PR EXCIS CHEST WALL TUMOR/RIBS
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 19260
|
| Min. Negotiated Rate |
$933.20 |
| Max. Negotiated Rate |
$1,749.75 |
| Rate for Payer: Aetna Medicare |
$1,166.50
|
| Rate for Payer: BCBS Complete |
$933.20
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,749.75
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,285.00
|
|
|
Service Code
|
HCPCS 15940
|
| Min. Negotiated Rate |
$423.66 |
| Max. Negotiated Rate |
$1,074.64 |
| Rate for Payer: Aetna Commercial |
$765.28
|
| Rate for Payer: Aetna Medicare |
$642.50
|
| Rate for Payer: BCBS Complete |
$444.84
|
| Rate for Payer: BCN Commercial |
$1,074.64
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Mclaren Medicaid |
$423.66
|
| Rate for Payer: Meridian Medicaid |
$444.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$983.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$983.58
|
| Rate for Payer: UHC Medicaid |
$423.66
|
| Rate for Payer: UHCCP Medicaid |
$423.66
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE
|
Professional
|
Both
|
$1,666.00
|
|
|
Service Code
|
HCPCS 15944
|
| Min. Negotiated Rate |
$542.72 |
| Max. Negotiated Rate |
$1,412.78 |
| Rate for Payer: Aetna Commercial |
$992.75
|
| Rate for Payer: Aetna Medicare |
$833.00
|
| Rate for Payer: BCBS Complete |
$569.86
|
| Rate for Payer: BCN Commercial |
$1,412.78
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Mclaren Medicaid |
$542.72
|
| Rate for Payer: Meridian Medicaid |
$569.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,249.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,293.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,293.05
|
| Rate for Payer: UHC Medicaid |
$542.72
|
| Rate for Payer: UHCCP Medicaid |
$542.72
|
|
|
PR EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$3,453.00
|
|
|
Service Code
|
HCPCS 15946
|
| Min. Negotiated Rate |
$931.45 |
| Max. Negotiated Rate |
$2,589.75 |
| Rate for Payer: Aetna Commercial |
$1,757.75
|
| Rate for Payer: Aetna Medicare |
$1,726.50
|
| Rate for Payer: BCBS Complete |
$978.02
|
| Rate for Payer: BCN Commercial |
$2,410.22
|
| Rate for Payer: Cash Price |
$2,762.40
|
| Rate for Payer: Cash Price |
$2,762.40
|
| Rate for Payer: Mclaren Medicaid |
$931.45
|
| Rate for Payer: Meridian Medicaid |
$978.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,589.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,205.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,205.98
|
| Rate for Payer: UHC Medicaid |
$931.45
|
| Rate for Payer: UHCCP Medicaid |
$931.45
|
|
|
PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 15941
|
| Min. Negotiated Rate |
$552.31 |
| Max. Negotiated Rate |
$1,432.20 |
| Rate for Payer: Aetna Commercial |
$1,001.30
|
| Rate for Payer: Aetna Medicare |
$832.00
|
| Rate for Payer: BCBS Complete |
$579.93
|
| Rate for Payer: BCN Commercial |
$1,432.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Mclaren Medicaid |
$552.31
|
| Rate for Payer: Meridian Medicaid |
$579.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,248.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,310.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,310.83
|
| Rate for Payer: UHC Medicaid |
$552.31
|
| Rate for Payer: UHCCP Medicaid |
$552.31
|
|
|
PR EXCISION 1ST &/CERVICAL RIB
|
Professional
|
Both
|
$1,238.00
|
|
|
Service Code
|
HCPCS 21615
|
| Min. Negotiated Rate |
$371.47 |
| Max. Negotiated Rate |
$1,000.24 |
| Rate for Payer: Aetna Commercial |
$825.88
|
| Rate for Payer: Aetna Medicare |
$619.00
|
| Rate for Payer: BCBS Complete |
$390.04
|
| Rate for Payer: BCN Commercial |
$935.71
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Mclaren Medicaid |
$371.47
|
| Rate for Payer: Meridian Medicaid |
$390.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$928.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,000.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,000.24
|
| Rate for Payer: UHC Medicaid |
$371.47
|
| Rate for Payer: UHCCP Medicaid |
$371.47
|
|
|
PR EXCISION AMPULLA VATER
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 48148
|
| Min. Negotiated Rate |
$751.25 |
| Max. Negotiated Rate |
$2,291.11 |
| Rate for Payer: Aetna Commercial |
$1,692.66
|
| Rate for Payer: Aetna Medicare |
$951.00
|
| Rate for Payer: BCBS Complete |
$788.81
|
| Rate for Payer: BCN Commercial |
$1,880.38
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Mclaren Medicaid |
$751.25
|
| Rate for Payer: Meridian Medicaid |
$788.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,426.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,291.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,291.11
|
| Rate for Payer: UHC Medicaid |
$751.25
|
| Rate for Payer: UHCCP Medicaid |
$751.25
|
|
|
PR EXCISION AURAL POLYP
|
Professional
|
Both
|
$387.00
|
|
|
Service Code
|
HCPCS 69540
|
| Min. Negotiated Rate |
$76.68 |
| Max. Negotiated Rate |
$290.25 |
| Rate for Payer: Aetna Commercial |
$142.01
|
| Rate for Payer: Aetna Medicare |
$193.50
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCN Commercial |
$194.71
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Mclaren Medicaid |
$76.68
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.39
|
| Rate for Payer: UHC Medicaid |
$76.68
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
|
|
PR EXCISION BARTHOLINS GLAND OR CYST
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 56740
|
| Min. Negotiated Rate |
$180.41 |
| Max. Negotiated Rate |
$717.75 |
| Rate for Payer: Aetna Commercial |
$372.87
|
| Rate for Payer: Aetna Medicare |
$478.50
|
| Rate for Payer: BCBS Complete |
$189.43
|
| Rate for Payer: BCN Commercial |
$471.59
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Mclaren Medicaid |
$180.41
|
| Rate for Payer: Meridian Medicaid |
$189.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$717.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$477.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$477.61
|
| Rate for Payer: UHC Medicaid |
$180.41
|
| Rate for Payer: UHCCP Medicaid |
$180.41
|
|
|
PR EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT
|
Professional
|
Both
|
$1,005.00
|
|
|
Service Code
|
HCPCS 21040
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$753.75 |
| Rate for Payer: Aetna Commercial |
$492.36
|
| Rate for Payer: Aetna Medicare |
$502.50
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCN Commercial |
$550.77
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Mclaren Medicaid |
$215.34
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$753.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$588.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.75
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
|
|
PR EXCISION BONE CYST/BENIGN TUMOR DEEP
|
Professional
|
Both
|
$1,542.00
|
|
|
Service Code
|
HCPCS 27066
|
| Min. Negotiated Rate |
$483.72 |
| Max. Negotiated Rate |
$1,335.08 |
| Rate for Payer: Aetna Commercial |
$1,089.99
|
| Rate for Payer: Aetna Medicare |
$771.00
|
| Rate for Payer: BCBS Complete |
$507.91
|
| Rate for Payer: BCN Commercial |
$1,248.94
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Mclaren Medicaid |
$483.72
|
| Rate for Payer: Meridian Medicaid |
$507.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,156.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,335.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,335.08
|
| Rate for Payer: UHC Medicaid |
$483.72
|
| Rate for Payer: UHCCP Medicaid |
$483.72
|
|
|
PR EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL
|
Professional
|
Both
|
$932.00
|
|
|
Service Code
|
HCPCS 27065
|
| Min. Negotiated Rate |
$324.19 |
| Max. Negotiated Rate |
$859.72 |
| Rate for Payer: Aetna Commercial |
$699.39
|
| Rate for Payer: Aetna Medicare |
$466.00
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCN Commercial |
$804.24
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Mclaren Medicaid |
$324.19
|
| Rate for Payer: Meridian Medicaid |
$340.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$699.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$859.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$859.72
|
| Rate for Payer: UHC Medicaid |
$324.19
|
| Rate for Payer: UHCCP Medicaid |
$324.19
|
|
|
PR EXCISION BONE MANDIBLE
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 21025
|
| Min. Negotiated Rate |
$391.28 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Aetna Commercial |
$883.19
|
| Rate for Payer: Aetna Medicare |
$822.00
|
| Rate for Payer: BCBS Complete |
$410.84
|
| Rate for Payer: BCN Commercial |
$1,009.90
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Mclaren Medicaid |
$391.28
|
| Rate for Payer: Meridian Medicaid |
$410.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,233.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,079.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,079.57
|
| Rate for Payer: UHC Medicaid |
$391.28
|
| Rate for Payer: UHCCP Medicaid |
$391.28
|
|
|
PR EXCISION CHALAZION MULTIPLE SAME LID
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 67801
|
| Min. Negotiated Rate |
$70.29 |
| Max. Negotiated Rate |
$228.66 |
| Rate for Payer: Aetna Commercial |
$171.99
|
| Rate for Payer: Aetna Medicare |
$150.00
|
| Rate for Payer: BCBS Complete |
$73.80
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Mclaren Medicaid |
$70.29
|
| Rate for Payer: Meridian Medicaid |
$73.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.66
|
| Rate for Payer: UHC Medicaid |
$70.29
|
| Rate for Payer: UHCCP Medicaid |
$70.29
|
|
|
PR EXCISION CHALAZION SINGLE
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 67800
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$178.49 |
| Rate for Payer: Aetna Commercial |
$133.72
|
| Rate for Payer: Aetna Medicare |
$101.50
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCN Commercial |
$120.17
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Mclaren Medicaid |
$55.38
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$178.49
|
| Rate for Payer: UHC Medicaid |
$55.38
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
|
PR EXCISION CHEST WALL TUMOR INCLUDING RIBS
|
Professional
|
Both
|
$2,512.00
|
|
|
Service Code
|
HCPCS 21601
|
| Min. Negotiated Rate |
$708.86 |
| Max. Negotiated Rate |
$1,884.00 |
| Rate for Payer: Aetna Commercial |
$1,569.63
|
| Rate for Payer: Aetna Medicare |
$1,256.00
|
| Rate for Payer: BCBS Complete |
$744.30
|
| Rate for Payer: BCN Commercial |
$1,716.54
|
| Rate for Payer: Cash Price |
$2,009.60
|
| Rate for Payer: Cash Price |
$2,009.60
|
| Rate for Payer: Mclaren Medicaid |
$708.86
|
| Rate for Payer: Meridian Medicaid |
$744.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,884.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$708.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,834.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,834.93
|
| Rate for Payer: UHC Medicaid |
$708.86
|
| Rate for Payer: UHCCP Medicaid |
$708.86
|
|
