|
PR REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 11008
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$566.30 |
| Rate for Payer: Aetna Commercial |
$363.45
|
| Rate for Payer: Aetna Medicare |
$282.08
|
| Rate for Payer: BCBS Complete |
$180.70
|
| Rate for Payer: BCBS MAPPO |
$271.23
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$394.85
|
| Rate for Payer: BCN Medicare Advantage |
$271.23
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$390.57
|
| Rate for Payer: Cofinity Commercial |
$363.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.23
|
| Rate for Payer: Mclaren Medicaid |
$172.10
|
| Rate for Payer: Meridian Medicaid |
$180.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$284.79
|
| Rate for Payer: PACE SWMI |
$271.23
|
| Rate for Payer: PHP Medicare Advantage |
$271.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.12
|
| Rate for Payer: Priority Health Medicare |
$271.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$332.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.23
|
| Rate for Payer: UHC Medicare Advantage |
$279.37
|
|
|
PR REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM
|
Professional
|
Both
|
$929.00
|
|
|
Service Code
|
HCPCS 23333
|
| Min. Negotiated Rate |
$75.14 |
| Max. Negotiated Rate |
$730.75 |
| Rate for Payer: Aetna Commercial |
$625.20
|
| Rate for Payer: Aetna Medicare |
$485.23
|
| Rate for Payer: BCBS Complete |
$324.07
|
| Rate for Payer: BCBS MAPPO |
$466.57
|
| Rate for Payer: BCBS Trust/PPO |
$75.14
|
| Rate for Payer: BCN Commercial |
$699.30
|
| Rate for Payer: BCN Medicare Advantage |
$466.57
|
| Rate for Payer: Cash Price |
$743.20
|
| Rate for Payer: Cash Price |
$743.20
|
| Rate for Payer: Cofinity Commercial |
$671.86
|
| Rate for Payer: Cofinity Commercial |
$625.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.57
|
| Rate for Payer: Mclaren Medicaid |
$308.64
|
| Rate for Payer: Meridian Medicaid |
$324.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$489.90
|
| Rate for Payer: PACE SWMI |
$466.57
|
| Rate for Payer: PHP Medicare Advantage |
$466.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$650.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$730.75
|
| Rate for Payer: Priority Health Medicare |
$466.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$730.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.57
|
| Rate for Payer: UHC Medicare Advantage |
$480.57
|
|
|
PR REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 11200
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$1,422.75 |
| Rate for Payer: Aetna Commercial |
$98.38
|
| Rate for Payer: Aetna Medicare |
$76.36
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS MAPPO |
$73.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.75
|
| Rate for Payer: BCN Commercial |
$107.59
|
| Rate for Payer: BCN Medicare Advantage |
$73.42
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$98.38
|
| Rate for Payer: Cofinity Commercial |
$105.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.42
|
| Rate for Payer: Mclaren Medicaid |
$49.20
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.09
|
| Rate for Payer: PACE SWMI |
$73.42
|
| Rate for Payer: PHP Medicare Advantage |
$73.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.71
|
| Rate for Payer: Priority Health Medicare |
$73.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.42
|
| Rate for Payer: UHC Medicare Advantage |
$75.62
|
|
|
PR REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 11201
|
| Min. Negotiated Rate |
$10.22 |
| Max. Negotiated Rate |
$106.97 |
| Rate for Payer: Aetna Commercial |
$21.75
|
| Rate for Payer: Aetna Medicare |
$16.88
|
| Rate for Payer: BCBS Complete |
$10.73
|
| Rate for Payer: BCBS MAPPO |
$16.23
|
| Rate for Payer: BCBS Trust/PPO |
$106.97
|
| Rate for Payer: BCN Commercial |
$21.60
|
| Rate for Payer: BCN Medicare Advantage |
$16.23
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$23.37
|
| Rate for Payer: Cofinity Commercial |
$21.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.23
|
| Rate for Payer: Mclaren Medicaid |
$10.22
|
| Rate for Payer: Meridian Medicaid |
$10.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.04
|
| Rate for Payer: PACE SWMI |
$16.23
|
| Rate for Payer: PHP Medicare Advantage |
$16.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.14
|
| Rate for Payer: Priority Health Medicare |
$16.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.23
|
| Rate for Payer: UHC Medicare Advantage |
$16.72
|
|
|
PR REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 33286
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$2,454.48 |
| Rate for Payer: Aetna Commercial |
$114.10
|
| Rate for Payer: Aetna Medicare |
$88.56
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS MAPPO |
$85.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,454.48
|
| Rate for Payer: BCN Commercial |
$192.54
|
| Rate for Payer: BCN Medicare Advantage |
$85.15
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$122.62
|
| Rate for Payer: Cofinity Commercial |
$114.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.15
|
| Rate for Payer: Mclaren Medicaid |
$53.68
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.41
|
| Rate for Payer: PACE SWMI |
$85.15
|
| Rate for Payer: PHP Medicare Advantage |
$85.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.65
|
| Rate for Payer: Priority Health Medicare |
$85.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$135.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.15
|
| Rate for Payer: UHC Medicare Advantage |
$87.70
|
|
|
PR REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 15854
|
| Min. Negotiated Rate |
$14.93 |
| Max. Negotiated Rate |
$452.03 |
| Rate for Payer: Aetna Commercial |
$20.01
|
| Rate for Payer: Aetna Medicare |
$15.53
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$14.93
|
| Rate for Payer: BCBS Trust/PPO |
$452.03
|
| Rate for Payer: BCN Commercial |
$23.46
|
| Rate for Payer: BCN Medicare Advantage |
$14.93
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$20.01
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.68
|
| Rate for Payer: PACE SWMI |
$14.93
|
| Rate for Payer: PHP Medicare Advantage |
$14.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.73
|
| Rate for Payer: Priority Health Medicare |
$14.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.93
|
| Rate for Payer: UHC Medicare Advantage |
$15.38
|
|
|
PR REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 15853
|
| Min. Negotiated Rate |
$10.55 |
| Max. Negotiated Rate |
$10,615.31 |
| Rate for Payer: Aetna Commercial |
$14.14
|
| Rate for Payer: Aetna Medicare |
$10.97
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$10.55
|
| Rate for Payer: BCBS Trust/PPO |
$10,615.31
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: BCN Medicare Advantage |
$10.55
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$14.14
|
| Rate for Payer: Cofinity Commercial |
$15.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.08
|
| Rate for Payer: PACE SWMI |
$10.55
|
| Rate for Payer: PHP Medicare Advantage |
$10.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.97
|
| Rate for Payer: Priority Health Medicare |
$10.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.55
|
| Rate for Payer: UHC Medicare Advantage |
$10.87
|
|
|
PR REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA
|
Professional
|
Both
|
$157.00
|
|
|
Service Code
|
HCPCS 15851
|
| Min. Negotiated Rate |
$41.54 |
| Max. Negotiated Rate |
$272.27 |
| Rate for Payer: Aetna Commercial |
$85.18
|
| Rate for Payer: Aetna Medicare |
$66.11
|
| Rate for Payer: BCBS Complete |
$43.62
|
| Rate for Payer: BCBS MAPPO |
$63.57
|
| Rate for Payer: BCBS Trust/PPO |
$272.27
|
| Rate for Payer: BCN Commercial |
$82.58
|
| Rate for Payer: BCN Medicare Advantage |
$63.57
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cofinity Commercial |
$91.54
|
| Rate for Payer: Cofinity Commercial |
$85.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.57
|
| Rate for Payer: Mclaren Medicaid |
$41.54
|
| Rate for Payer: Meridian Medicaid |
$43.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.75
|
| Rate for Payer: PACE SWMI |
$63.57
|
| Rate for Payer: PHP Medicare Advantage |
$63.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.33
|
| Rate for Payer: Priority Health Medicare |
$63.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.57
|
| Rate for Payer: UHC Medicare Advantage |
$65.48
|
|
|
PR REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 15850
|
| Min. Negotiated Rate |
$88.80 |
| Max. Negotiated Rate |
$155.40 |
| Rate for Payer: BCBS Complete |
$88.80
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.40
|
|
|
PR REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 11971
|
| Min. Negotiated Rate |
$355.50 |
| Max. Negotiated Rate |
$807.78 |
| Rate for Payer: Aetna Commercial |
$721.62
|
| Rate for Payer: Aetna Medicare |
$560.06
|
| Rate for Payer: BCBS Complete |
$373.28
|
| Rate for Payer: BCBS MAPPO |
$538.52
|
| Rate for Payer: BCBS Trust/PPO |
$394.67
|
| Rate for Payer: BCN Commercial |
$807.78
|
| Rate for Payer: BCN Medicare Advantage |
$538.52
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$775.47
|
| Rate for Payer: Cofinity Commercial |
$721.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.52
|
| Rate for Payer: Mclaren Medicaid |
$355.50
|
| Rate for Payer: Meridian Medicaid |
$373.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$565.45
|
| Rate for Payer: PACE SWMI |
$538.52
|
| Rate for Payer: PHP Medicare Advantage |
$538.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.45
|
| Rate for Payer: Priority Health Medicare |
$538.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$679.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$538.52
|
| Rate for Payer: UHC Medicare Advantage |
$554.68
|
|
|
PR REMOVAL TUNNELED INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$962.00
|
|
|
Service Code
|
HCPCS 49422
|
| Min. Negotiated Rate |
$140.15 |
| Max. Negotiated Rate |
$906.56 |
| Rate for Payer: Aetna Commercial |
$293.94
|
| Rate for Payer: Aetna Medicare |
$228.13
|
| Rate for Payer: BCBS Complete |
$147.16
|
| Rate for Payer: BCBS MAPPO |
$219.36
|
| Rate for Payer: BCBS Trust/PPO |
$906.56
|
| Rate for Payer: BCN Commercial |
$320.09
|
| Rate for Payer: BCN Medicare Advantage |
$219.36
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cofinity Commercial |
$315.88
|
| Rate for Payer: Cofinity Commercial |
$293.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.36
|
| Rate for Payer: Mclaren Medicaid |
$140.15
|
| Rate for Payer: Meridian Medicaid |
$147.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.33
|
| Rate for Payer: PACE SWMI |
$219.36
|
| Rate for Payer: PHP Medicare Advantage |
$219.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$385.12
|
| Rate for Payer: Priority Health Medicare |
$219.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.36
|
| Rate for Payer: UHC Medicare Advantage |
$225.94
|
|
|
PR REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE
|
Professional
|
Both
|
$3,314.00
|
|
|
Service Code
|
HCPCS 33977
|
| Min. Negotiated Rate |
$107.24 |
| Max. Negotiated Rate |
$2,319.80 |
| Rate for Payer: Aetna Commercial |
$1,476.67
|
| Rate for Payer: Aetna Medicare |
$1,146.07
|
| Rate for Payer: BCBS Complete |
$736.26
|
| Rate for Payer: BCBS MAPPO |
$1,101.99
|
| Rate for Payer: BCBS Trust/PPO |
$107.24
|
| Rate for Payer: BCN Commercial |
$1,602.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,101.99
|
| Rate for Payer: Cash Price |
$2,651.20
|
| Rate for Payer: Cash Price |
$2,651.20
|
| Rate for Payer: Cofinity Commercial |
$1,586.87
|
| Rate for Payer: Cofinity Commercial |
$1,476.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.99
|
| Rate for Payer: Mclaren Medicaid |
$701.20
|
| Rate for Payer: Meridian Medicaid |
$736.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,157.09
|
| Rate for Payer: PACE SWMI |
$1,101.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,101.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$701.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,319.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,744.82
|
| Rate for Payer: Priority Health Medicare |
$1,101.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,744.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,101.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,101.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,135.05
|
|
|
PR REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST
|
Professional
|
Both
|
$1,325.00
|
|
|
Service Code
|
HCPCS 25251
|
| Min. Negotiated Rate |
$466.90 |
| Max. Negotiated Rate |
$2,000.67 |
| Rate for Payer: Aetna Commercial |
$952.95
|
| Rate for Payer: Aetna Medicare |
$739.61
|
| Rate for Payer: BCBS Complete |
$490.24
|
| Rate for Payer: BCBS MAPPO |
$711.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,000.67
|
| Rate for Payer: BCN Commercial |
$1,061.41
|
| Rate for Payer: BCN Medicare Advantage |
$711.16
|
| Rate for Payer: Cash Price |
$1,060.00
|
| Rate for Payer: Cash Price |
$1,060.00
|
| Rate for Payer: Cofinity Commercial |
$1,024.07
|
| Rate for Payer: Cofinity Commercial |
$952.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.16
|
| Rate for Payer: Mclaren Medicaid |
$466.90
|
| Rate for Payer: Meridian Medicaid |
$490.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$746.72
|
| Rate for Payer: PACE SWMI |
$711.16
|
| Rate for Payer: PHP Medicare Advantage |
$711.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$927.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.13
|
| Rate for Payer: Priority Health Medicare |
$711.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$711.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$711.16
|
| Rate for Payer: UHC Medicare Advantage |
$732.49
|
|
|
PR REMOVE BILE DUCT STONE, PERCUT
|
Professional
|
Both
|
$886.00
|
|
|
Service Code
|
HCPCS 47630
|
| Min. Negotiated Rate |
$354.40 |
| Max. Negotiated Rate |
$620.20 |
| Rate for Payer: BCBS Complete |
$354.40
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.20
|
|
|
PR REMOVE DEEP SHOULDER FOREIGN BODY
|
Professional
|
Both
|
$1,019.00
|
|
|
Service Code
|
HCPCS 23331
|
| Min. Negotiated Rate |
$407.60 |
| Max. Negotiated Rate |
$713.30 |
| Rate for Payer: BCBS Complete |
$407.60
|
| Rate for Payer: Cash Price |
$815.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.30
|
|
|
PR REMOVE NAIL BED/FINGER TIP
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 11752
|
| Min. Negotiated Rate |
$208.00 |
| Max. Negotiated Rate |
$364.00 |
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.00
|
|
|
PR REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL
|
Professional
|
Both
|
$2,052.00
|
|
|
Service Code
|
HCPCS 50385
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$2,060.90 |
| Rate for Payer: Aetna Commercial |
$282.31
|
| Rate for Payer: Aetna Medicare |
$219.11
|
| Rate for Payer: BCBS Complete |
$141.12
|
| Rate for Payer: BCBS MAPPO |
$210.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,060.90
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: BCN Medicare Advantage |
$210.68
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cofinity Commercial |
$282.31
|
| Rate for Payer: Cofinity Commercial |
$303.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.68
|
| Rate for Payer: Mclaren Medicaid |
$134.40
|
| Rate for Payer: Meridian Medicaid |
$141.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$221.21
|
| Rate for Payer: PACE SWMI |
$210.68
|
| Rate for Payer: PHP Medicare Advantage |
$210.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,436.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$342.05
|
| Rate for Payer: Priority Health Medicare |
$210.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.68
|
| Rate for Payer: UHC Medicare Advantage |
$217.00
|
|
|
PR REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,886.00
|
|
|
Service Code
|
HCPCS 53446
|
| Min. Negotiated Rate |
$410.24 |
| Max. Negotiated Rate |
$1,320.20 |
| Rate for Payer: Aetna Commercial |
$839.93
|
| Rate for Payer: Aetna Medicare |
$651.88
|
| Rate for Payer: BCBS Complete |
$430.75
|
| Rate for Payer: BCBS MAPPO |
$626.81
|
| Rate for Payer: BCBS Trust/PPO |
$437.96
|
| Rate for Payer: BCN Commercial |
$928.00
|
| Rate for Payer: BCN Medicare Advantage |
$626.81
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cofinity Commercial |
$902.61
|
| Rate for Payer: Cofinity Commercial |
$839.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.81
|
| Rate for Payer: Mclaren Medicaid |
$410.24
|
| Rate for Payer: Meridian Medicaid |
$430.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$658.15
|
| Rate for Payer: PACE SWMI |
$626.81
|
| Rate for Payer: PHP Medicare Advantage |
$626.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,026.14
|
| Rate for Payer: Priority Health Medicare |
$626.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$626.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.81
|
| Rate for Payer: UHC Medicare Advantage |
$645.61
|
|
|
PR REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD
|
Professional
|
Both
|
$688.00
|
|
|
Service Code
|
HCPCS 33227
|
| Min. Negotiated Rate |
$213.64 |
| Max. Negotiated Rate |
$1,104.68 |
| Rate for Payer: Aetna Commercial |
$445.31
|
| Rate for Payer: Aetna Medicare |
$345.61
|
| Rate for Payer: BCBS Complete |
$224.32
|
| Rate for Payer: BCBS MAPPO |
$332.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.68
|
| Rate for Payer: BCN Commercial |
$490.63
|
| Rate for Payer: BCN Medicare Advantage |
$332.32
|
| Rate for Payer: Cash Price |
$550.40
|
| Rate for Payer: Cash Price |
$550.40
|
| Rate for Payer: Cofinity Commercial |
$445.31
|
| Rate for Payer: Cofinity Commercial |
$478.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.32
|
| Rate for Payer: Mclaren Medicaid |
$213.64
|
| Rate for Payer: Meridian Medicaid |
$224.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$348.94
|
| Rate for Payer: PACE SWMI |
$332.32
|
| Rate for Payer: PHP Medicare Advantage |
$332.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$481.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.09
|
| Rate for Payer: Priority Health Medicare |
$332.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$534.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.32
|
| Rate for Payer: UHC Medicare Advantage |
$342.29
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS
|
Professional
|
Both
|
$713.00
|
|
|
Service Code
|
HCPCS 33228
|
| Min. Negotiated Rate |
$223.01 |
| Max. Negotiated Rate |
$864.30 |
| Rate for Payer: Aetna Commercial |
$464.90
|
| Rate for Payer: Aetna Medicare |
$360.82
|
| Rate for Payer: BCBS Complete |
$234.16
|
| Rate for Payer: BCBS MAPPO |
$346.94
|
| Rate for Payer: BCBS Trust/PPO |
$864.30
|
| Rate for Payer: BCN Commercial |
$512.14
|
| Rate for Payer: BCN Medicare Advantage |
$346.94
|
| Rate for Payer: Cash Price |
$570.40
|
| Rate for Payer: Cash Price |
$570.40
|
| Rate for Payer: Cofinity Commercial |
$499.59
|
| Rate for Payer: Cofinity Commercial |
$464.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.94
|
| Rate for Payer: Mclaren Medicaid |
$223.01
|
| Rate for Payer: Meridian Medicaid |
$234.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$364.29
|
| Rate for Payer: PACE SWMI |
$346.94
|
| Rate for Payer: PHP Medicare Advantage |
$346.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.49
|
| Rate for Payer: Priority Health Medicare |
$346.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.94
|
| Rate for Payer: UHC Medicare Advantage |
$357.35
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD
|
Professional
|
Both
|
$567.00
|
|
|
Service Code
|
HCPCS 33229
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$1,010.11 |
| Rate for Payer: Aetna Commercial |
$491.34
|
| Rate for Payer: Aetna Medicare |
$381.34
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCBS MAPPO |
$366.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.11
|
| Rate for Payer: BCN Commercial |
$541.46
|
| Rate for Payer: BCN Medicare Advantage |
$366.67
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cofinity Commercial |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$491.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.67
|
| Rate for Payer: Mclaren Medicaid |
$234.51
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.00
|
| Rate for Payer: PACE SWMI |
$366.67
|
| Rate for Payer: PHP Medicare Advantage |
$366.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$396.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.41
|
| Rate for Payer: Priority Health Medicare |
$366.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$589.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.67
|
| Rate for Payer: UHC Medicare Advantage |
$377.67
|
|
|
PR REMV TISSUE FOR GRAFT OTHR
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 20926
|
| Min. Negotiated Rate |
$321.20 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: BCBS Complete |
$321.20
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.10
|
|
|
PR RENAL ANGIO, CARDIAC CATH
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS G0275
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.50
|
|
|
PR RENAL BIOPSY SURG EXPOSURE KIDNEY
|
Professional
|
Both
|
$1,666.00
|
|
|
Service Code
|
HCPCS 50205
|
| Min. Negotiated Rate |
$483.72 |
| Max. Negotiated Rate |
$2,575.99 |
| Rate for Payer: Aetna Commercial |
$1,003.53
|
| Rate for Payer: Aetna Medicare |
$778.86
|
| Rate for Payer: BCBS Complete |
$507.91
|
| Rate for Payer: BCBS MAPPO |
$748.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,575.99
|
| Rate for Payer: BCN Commercial |
$1,101.48
|
| Rate for Payer: BCN Medicare Advantage |
$748.90
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cofinity Commercial |
$1,078.42
|
| Rate for Payer: Cofinity Commercial |
$1,003.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$748.90
|
| Rate for Payer: Mclaren Medicaid |
$483.72
|
| Rate for Payer: Meridian Medicaid |
$507.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$786.34
|
| Rate for Payer: PACE SWMI |
$748.90
|
| Rate for Payer: PHP Medicare Advantage |
$748.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,166.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,217.97
|
| Rate for Payer: Priority Health Medicare |
$748.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,217.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$748.90
|
| Rate for Payer: UHC Medicare Advantage |
$771.37
|
|
|
PR RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$712.00
|
|
|
Service Code
|
HCPCS 50551
|
| Min. Negotiated Rate |
$184.46 |
| Max. Negotiated Rate |
$3,748.82 |
| Rate for Payer: Aetna Commercial |
$383.37
|
| Rate for Payer: Aetna Medicare |
$297.54
|
| Rate for Payer: BCBS Complete |
$193.68
|
| Rate for Payer: BCBS MAPPO |
$286.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,748.82
|
| Rate for Payer: BCN Commercial |
$522.88
|
| Rate for Payer: BCN Medicare Advantage |
$286.10
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cofinity Commercial |
$383.37
|
| Rate for Payer: Cofinity Commercial |
$411.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.10
|
| Rate for Payer: Mclaren Medicaid |
$184.46
|
| Rate for Payer: Meridian Medicaid |
$193.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$300.40
|
| Rate for Payer: PACE SWMI |
$286.10
|
| Rate for Payer: PHP Medicare Advantage |
$286.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.71
|
| Rate for Payer: Priority Health Medicare |
$286.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$464.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$286.10
|
| Rate for Payer: UHC Medicare Advantage |
$294.68
|
|
