|
PR RPR LG OMPHALOCELE/GASTROSCHISIS RMVL PROSTH
|
Professional
|
Both
|
$3,342.00
|
|
|
Service Code
|
HCPCS 49606
|
| Min. Negotiated Rate |
$726.33 |
| Max. Negotiated Rate |
$2,339.40 |
| Rate for Payer: Aetna Commercial |
$1,516.88
|
| Rate for Payer: Aetna Medicare |
$1,177.28
|
| Rate for Payer: BCBS Complete |
$762.65
|
| Rate for Payer: BCBS MAPPO |
$1,132.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.86
|
| Rate for Payer: BCN Commercial |
$1,659.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,132.00
|
| Rate for Payer: Cash Price |
$2,673.60
|
| Rate for Payer: Cash Price |
$2,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,630.08
|
| Rate for Payer: Cofinity Commercial |
$1,516.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,132.00
|
| Rate for Payer: Mclaren Medicaid |
$726.33
|
| Rate for Payer: Meridian Medicaid |
$762.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,188.60
|
| Rate for Payer: PACE SWMI |
$1,132.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,132.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$726.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,339.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,996.17
|
| Rate for Payer: Priority Health Medicare |
$1,132.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,996.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,132.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,132.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,165.96
|
|
|
PR RPR LG OMPHALOCELE/GASTROSCHISIS W/WO PROSTH
|
Professional
|
Both
|
$8,940.00
|
|
|
Service Code
|
HCPCS 49605
|
| Min. Negotiated Rate |
$2,106.86 |
| Max. Negotiated Rate |
$8,595.58 |
| Rate for Payer: Aetna Commercial |
$6,563.25
|
| Rate for Payer: Aetna Medicare |
$5,093.87
|
| Rate for Payer: BCBS Complete |
$3,280.05
|
| Rate for Payer: BCBS MAPPO |
$4,897.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.86
|
| Rate for Payer: BCN Commercial |
$7,143.98
|
| Rate for Payer: BCN Medicare Advantage |
$4,897.95
|
| Rate for Payer: Cash Price |
$7,152.00
|
| Rate for Payer: Cash Price |
$7,152.00
|
| Rate for Payer: Cofinity Commercial |
$7,053.05
|
| Rate for Payer: Cofinity Commercial |
$6,563.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,897.95
|
| Rate for Payer: Mclaren Medicaid |
$3,123.86
|
| Rate for Payer: Meridian Medicaid |
$3,280.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,142.85
|
| Rate for Payer: PACE SWMI |
$4,897.95
|
| Rate for Payer: PHP Medicare Advantage |
$4,897.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,123.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,258.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,595.58
|
| Rate for Payer: Priority Health Medicare |
$4,897.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,595.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,897.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,897.95
|
| Rate for Payer: UHC Medicare Advantage |
$5,044.89
|
|
|
PR RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT
|
Professional
|
Both
|
$964.00
|
|
|
Service Code
|
HCPCS 40652
|
| Min. Negotiated Rate |
$233.45 |
| Max. Negotiated Rate |
$765.27 |
| Rate for Payer: Aetna Commercial |
$472.36
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: BCBS Complete |
$245.12
|
| Rate for Payer: BCBS MAPPO |
$352.51
|
| Rate for Payer: BCBS Trust/PPO |
$649.28
|
| Rate for Payer: BCN Commercial |
$765.27
|
| Rate for Payer: BCN Medicare Advantage |
$352.51
|
| Rate for Payer: Cash Price |
$771.20
|
| Rate for Payer: Cash Price |
$771.20
|
| Rate for Payer: Cofinity Commercial |
$472.36
|
| Rate for Payer: Cofinity Commercial |
$507.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.51
|
| Rate for Payer: Mclaren Medicaid |
$233.45
|
| Rate for Payer: Meridian Medicaid |
$245.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$370.14
|
| Rate for Payer: PACE SWMI |
$352.51
|
| Rate for Payer: PHP Medicare Advantage |
$352.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$637.96
|
| Rate for Payer: Priority Health Medicare |
$352.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$637.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.51
|
| Rate for Payer: UHC Medicare Advantage |
$363.09
|
|
|
PR RPR LIP FULL THICKNESS VERMILION ONLY
|
Professional
|
Both
|
$679.00
|
|
|
Service Code
|
HCPCS 40650
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$709.07 |
| Rate for Payer: Aetna Commercial |
$411.67
|
| Rate for Payer: Aetna Medicare |
$319.51
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCBS MAPPO |
$307.22
|
| Rate for Payer: BCBS Trust/PPO |
$462.26
|
| Rate for Payer: BCN Commercial |
$709.07
|
| Rate for Payer: BCN Medicare Advantage |
$307.22
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cofinity Commercial |
$442.40
|
| Rate for Payer: Cofinity Commercial |
$411.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.22
|
| Rate for Payer: Mclaren Medicaid |
$204.91
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$322.58
|
| Rate for Payer: PACE SWMI |
$307.22
|
| Rate for Payer: PHP Medicare Advantage |
$307.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$555.63
|
| Rate for Payer: Priority Health Medicare |
$307.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$555.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$307.22
|
| Rate for Payer: UHC Medicare Advantage |
$316.44
|
|
|
PR RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE
|
Professional
|
Both
|
$743.00
|
|
|
Service Code
|
HCPCS 40654
|
| Min. Negotiated Rate |
$275.20 |
| Max. Negotiated Rate |
$861.54 |
| Rate for Payer: Aetna Commercial |
$556.97
|
| Rate for Payer: Aetna Medicare |
$432.28
|
| Rate for Payer: BCBS Complete |
$288.96
|
| Rate for Payer: BCBS MAPPO |
$415.65
|
| Rate for Payer: BCBS Trust/PPO |
$842.64
|
| Rate for Payer: BCN Commercial |
$861.54
|
| Rate for Payer: BCN Medicare Advantage |
$415.65
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cofinity Commercial |
$556.97
|
| Rate for Payer: Cofinity Commercial |
$598.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.65
|
| Rate for Payer: Mclaren Medicaid |
$275.20
|
| Rate for Payer: Meridian Medicaid |
$288.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$436.43
|
| Rate for Payer: PACE SWMI |
$415.65
|
| Rate for Payer: PHP Medicare Advantage |
$415.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$520.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.43
|
| Rate for Payer: Priority Health Medicare |
$415.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$751.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$415.65
|
| Rate for Payer: UHC Medicare Advantage |
$428.12
|
|
|
PR RPR LW IMPERFORATE ANUS W/ANOPRNL FSTL CUT-BK
|
Professional
|
Both
|
$1,165.00
|
|
|
Service Code
|
HCPCS 46715
|
| Min. Negotiated Rate |
$231.40 |
| Max. Negotiated Rate |
$982.51 |
| Rate for Payer: Aetna Commercial |
$736.44
|
| Rate for Payer: Aetna Medicare |
$571.56
|
| Rate for Payer: BCBS Complete |
$375.28
|
| Rate for Payer: BCBS MAPPO |
$549.58
|
| Rate for Payer: BCBS Trust/PPO |
$231.40
|
| Rate for Payer: BCN Commercial |
$816.58
|
| Rate for Payer: BCN Medicare Advantage |
$549.58
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$736.44
|
| Rate for Payer: Cofinity Commercial |
$791.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.58
|
| Rate for Payer: Mclaren Medicaid |
$357.41
|
| Rate for Payer: Meridian Medicaid |
$375.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$577.06
|
| Rate for Payer: PACE SWMI |
$549.58
|
| Rate for Payer: PHP Medicare Advantage |
$549.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$815.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$982.51
|
| Rate for Payer: Priority Health Medicare |
$549.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$982.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.58
|
| Rate for Payer: UHC Medicare Advantage |
$566.07
|
|
|
PR RPR LW IMPERFORATE ANUS W/TRPOS FISTULA
|
Professional
|
Both
|
$2,933.00
|
|
|
Service Code
|
HCPCS 46716
|
| Min. Negotiated Rate |
$117.81 |
| Max. Negotiated Rate |
$2,174.92 |
| Rate for Payer: Aetna Commercial |
$1,633.96
|
| Rate for Payer: Aetna Medicare |
$1,268.14
|
| Rate for Payer: BCBS Complete |
$833.32
|
| Rate for Payer: BCBS MAPPO |
$1,219.37
|
| Rate for Payer: BCBS Trust/PPO |
$117.81
|
| Rate for Payer: BCN Commercial |
$1,807.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,219.37
|
| Rate for Payer: Cash Price |
$2,346.40
|
| Rate for Payer: Cash Price |
$2,346.40
|
| Rate for Payer: Cofinity Commercial |
$1,755.89
|
| Rate for Payer: Cofinity Commercial |
$1,633.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,219.37
|
| Rate for Payer: Mclaren Medicaid |
$793.64
|
| Rate for Payer: Meridian Medicaid |
$833.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,280.34
|
| Rate for Payer: PACE SWMI |
$1,219.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,219.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$793.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,053.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,174.92
|
| Rate for Payer: Priority Health Medicare |
$1,219.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,174.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,219.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,219.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,255.95
|
|
|
PR RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ
|
Professional
|
Both
|
$10,076.00
|
|
|
Service Code
|
HCPCS 39503
|
| Min. Negotiated Rate |
$516.15 |
| Max. Negotiated Rate |
$9,074.67 |
| Rate for Payer: Aetna Commercial |
$7,693.40
|
| Rate for Payer: Aetna Medicare |
$5,970.99
|
| Rate for Payer: BCBS Complete |
$3,824.42
|
| Rate for Payer: BCBS MAPPO |
$5,741.34
|
| Rate for Payer: BCBS Trust/PPO |
$516.15
|
| Rate for Payer: BCN Commercial |
$8,336.35
|
| Rate for Payer: BCN Medicare Advantage |
$5,741.34
|
| Rate for Payer: Cash Price |
$8,060.80
|
| Rate for Payer: Cash Price |
$8,060.80
|
| Rate for Payer: Cofinity Commercial |
$8,267.53
|
| Rate for Payer: Cofinity Commercial |
$7,693.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,741.34
|
| Rate for Payer: Mclaren Medicaid |
$3,642.30
|
| Rate for Payer: Meridian Medicaid |
$3,824.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,028.41
|
| Rate for Payer: PACE SWMI |
$5,741.34
|
| Rate for Payer: PHP Medicare Advantage |
$5,741.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,642.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,053.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,074.67
|
| Rate for Payer: Priority Health Medicare |
$5,741.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,074.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,741.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,741.34
|
| Rate for Payer: UHC Medicare Advantage |
$5,913.58
|
|
|
PR RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,142.00
|
|
|
Service Code
|
HCPCS 53449
|
| Min. Negotiated Rate |
$319.62 |
| Max. Negotiated Rate |
$981.29 |
| Rate for Payer: Aetna Commercial |
$803.50
|
| Rate for Payer: Aetna Medicare |
$623.62
|
| Rate for Payer: BCBS Complete |
$410.62
|
| Rate for Payer: BCBS MAPPO |
$599.63
|
| Rate for Payer: BCBS Trust/PPO |
$319.62
|
| Rate for Payer: BCN Commercial |
$887.44
|
| Rate for Payer: BCN Medicare Advantage |
$599.63
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cofinity Commercial |
$863.47
|
| Rate for Payer: Cofinity Commercial |
$803.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.63
|
| Rate for Payer: Mclaren Medicaid |
$391.07
|
| Rate for Payer: Meridian Medicaid |
$410.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$629.61
|
| Rate for Payer: PACE SWMI |
$599.63
|
| Rate for Payer: PHP Medicare Advantage |
$599.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$799.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$981.29
|
| Rate for Payer: Priority Health Medicare |
$599.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$981.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$599.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.63
|
| Rate for Payer: UHC Medicare Advantage |
$617.62
|
|
|
PR RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE
|
Professional
|
Both
|
$3,789.00
|
|
|
Service Code
|
HCPCS 27472
|
| Min. Negotiated Rate |
$522.49 |
| Max. Negotiated Rate |
$2,652.30 |
| Rate for Payer: Aetna Commercial |
$1,670.34
|
| Rate for Payer: Aetna Medicare |
$1,296.38
|
| Rate for Payer: BCBS Complete |
$852.78
|
| Rate for Payer: BCBS MAPPO |
$1,246.52
|
| Rate for Payer: BCBS Trust/PPO |
$522.49
|
| Rate for Payer: BCN Commercial |
$1,850.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,246.52
|
| Rate for Payer: Cash Price |
$3,031.20
|
| Rate for Payer: Cash Price |
$3,031.20
|
| Rate for Payer: Cofinity Commercial |
$1,794.99
|
| Rate for Payer: Cofinity Commercial |
$1,670.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,246.52
|
| Rate for Payer: Mclaren Medicaid |
$812.17
|
| Rate for Payer: Meridian Medicaid |
$852.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,308.85
|
| Rate for Payer: PACE SWMI |
$1,246.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,246.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,933.83
|
| Rate for Payer: Priority Health Medicare |
$1,246.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,933.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,246.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,246.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,283.92
|
|
|
PR RPR NON/MAL FEMUR DSTL H/N W/O GRF
|
Professional
|
Both
|
$2,870.00
|
|
|
Service Code
|
HCPCS 27470
|
| Min. Negotiated Rate |
$266.79 |
| Max. Negotiated Rate |
$2,009.00 |
| Rate for Payer: Aetna Commercial |
$1,558.62
|
| Rate for Payer: Aetna Medicare |
$1,209.68
|
| Rate for Payer: BCBS Complete |
$797.54
|
| Rate for Payer: BCBS MAPPO |
$1,163.15
|
| Rate for Payer: BCBS Trust/PPO |
$266.79
|
| Rate for Payer: BCN Commercial |
$1,728.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,163.15
|
| Rate for Payer: Cash Price |
$2,296.00
|
| Rate for Payer: Cash Price |
$2,296.00
|
| Rate for Payer: Cofinity Commercial |
$1,558.62
|
| Rate for Payer: Cofinity Commercial |
$1,674.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,163.15
|
| Rate for Payer: Mclaren Medicaid |
$759.56
|
| Rate for Payer: Meridian Medicaid |
$797.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,221.31
|
| Rate for Payer: PACE SWMI |
$1,163.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,163.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$759.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,009.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,806.68
|
| Rate for Payer: Priority Health Medicare |
$1,163.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,806.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,163.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,163.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,198.04
|
|
|
PR RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH
|
Professional
|
Both
|
$5,315.00
|
|
|
Service Code
|
HCPCS 27725
|
| Min. Negotiated Rate |
$782.78 |
| Max. Negotiated Rate |
$3,720.50 |
| Rate for Payer: Aetna Commercial |
$1,603.11
|
| Rate for Payer: Aetna Medicare |
$1,244.20
|
| Rate for Payer: BCBS Complete |
$821.92
|
| Rate for Payer: BCBS MAPPO |
$1,196.35
|
| Rate for Payer: BCBS Trust/PPO |
$800.37
|
| Rate for Payer: BCN Commercial |
$1,779.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,196.35
|
| Rate for Payer: Cash Price |
$4,252.00
|
| Rate for Payer: Cash Price |
$4,252.00
|
| Rate for Payer: Cofinity Commercial |
$1,603.11
|
| Rate for Payer: Cofinity Commercial |
$1,722.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,196.35
|
| Rate for Payer: Mclaren Medicaid |
$782.78
|
| Rate for Payer: Meridian Medicaid |
$821.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,256.17
|
| Rate for Payer: PACE SWMI |
$1,196.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,196.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$782.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,720.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,859.78
|
| Rate for Payer: Priority Health Medicare |
$1,196.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,859.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,196.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,196.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,232.24
|
|
|
PR RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT
|
Professional
|
Both
|
$4,677.00
|
|
|
Service Code
|
HCPCS 27724
|
| Min. Negotiated Rate |
$322.79 |
| Max. Negotiated Rate |
$3,273.90 |
| Rate for Payer: Aetna Commercial |
$1,659.97
|
| Rate for Payer: Aetna Medicare |
$1,288.33
|
| Rate for Payer: BCBS Complete |
$844.05
|
| Rate for Payer: BCBS MAPPO |
$1,238.78
|
| Rate for Payer: BCBS Trust/PPO |
$322.79
|
| Rate for Payer: BCN Commercial |
$1,834.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,238.78
|
| Rate for Payer: Cash Price |
$3,741.60
|
| Rate for Payer: Cash Price |
$3,741.60
|
| Rate for Payer: Cofinity Commercial |
$1,783.84
|
| Rate for Payer: Cofinity Commercial |
$1,659.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,238.78
|
| Rate for Payer: Mclaren Medicaid |
$803.86
|
| Rate for Payer: Meridian Medicaid |
$844.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,300.72
|
| Rate for Payer: PACE SWMI |
$1,238.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,238.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$803.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,273.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,916.99
|
| Rate for Payer: Priority Health Medicare |
$1,238.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,916.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,238.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,238.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,275.94
|
|
|
PR RPR NON/MALUNION METARSAL W/WO BONE GRAFT
|
Professional
|
Both
|
$1,290.00
|
|
|
Service Code
|
HCPCS 28322
|
| Min. Negotiated Rate |
$373.39 |
| Max. Negotiated Rate |
$2,539.54 |
| Rate for Payer: Aetna Commercial |
$761.37
|
| Rate for Payer: Aetna Medicare |
$590.92
|
| Rate for Payer: BCBS Complete |
$392.06
|
| Rate for Payer: BCBS MAPPO |
$568.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.54
|
| Rate for Payer: BCN Commercial |
$1,150.84
|
| Rate for Payer: BCN Medicare Advantage |
$568.19
|
| Rate for Payer: Cash Price |
$1,032.00
|
| Rate for Payer: Cash Price |
$1,032.00
|
| Rate for Payer: Cofinity Commercial |
$761.37
|
| Rate for Payer: Cofinity Commercial |
$818.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$568.19
|
| Rate for Payer: Mclaren Medicaid |
$373.39
|
| Rate for Payer: Meridian Medicaid |
$392.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$596.60
|
| Rate for Payer: PACE SWMI |
$568.19
|
| Rate for Payer: PHP Medicare Advantage |
$568.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$373.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$903.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$885.46
|
| Rate for Payer: Priority Health Medicare |
$568.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$885.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$568.19
|
| Rate for Payer: UHC Medicare Advantage |
$585.24
|
|
|
PR RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS
|
Professional
|
Both
|
$6,887.00
|
|
|
Service Code
|
HCPCS 33496
|
| Min. Negotiated Rate |
$807.24 |
| Max. Negotiated Rate |
$4,820.90 |
| Rate for Payer: Aetna Commercial |
$2,188.77
|
| Rate for Payer: Aetna Medicare |
$1,698.75
|
| Rate for Payer: BCBS Complete |
$1,092.98
|
| Rate for Payer: BCBS MAPPO |
$1,633.41
|
| Rate for Payer: BCBS Trust/PPO |
$807.24
|
| Rate for Payer: BCN Commercial |
$2,383.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,633.41
|
| Rate for Payer: Cash Price |
$5,509.60
|
| Rate for Payer: Cash Price |
$5,509.60
|
| Rate for Payer: Cofinity Commercial |
$2,188.77
|
| Rate for Payer: Cofinity Commercial |
$2,352.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,633.41
|
| Rate for Payer: Mclaren Medicaid |
$1,040.93
|
| Rate for Payer: Meridian Medicaid |
$1,092.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,715.08
|
| Rate for Payer: PACE SWMI |
$1,633.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,633.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,040.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,820.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,594.89
|
| Rate for Payer: Priority Health Medicare |
$1,633.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,594.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,633.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,633.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,682.41
|
|
|
PR RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$3,177.00
|
|
|
Service Code
|
HCPCS 25405
|
| Min. Negotiated Rate |
$25.89 |
| Max. Negotiated Rate |
$2,223.90 |
| Rate for Payer: Aetna Commercial |
$1,369.23
|
| Rate for Payer: Aetna Medicare |
$1,062.68
|
| Rate for Payer: BCBS Complete |
$700.92
|
| Rate for Payer: BCBS MAPPO |
$1,021.81
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$1,520.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,021.81
|
| Rate for Payer: Cash Price |
$2,541.60
|
| Rate for Payer: Cash Price |
$2,541.60
|
| Rate for Payer: Cofinity Commercial |
$1,471.41
|
| Rate for Payer: Cofinity Commercial |
$1,369.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,021.81
|
| Rate for Payer: Mclaren Medicaid |
$667.54
|
| Rate for Payer: Meridian Medicaid |
$700.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,072.90
|
| Rate for Payer: PACE SWMI |
$1,021.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,021.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,223.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,589.14
|
| Rate for Payer: Priority Health Medicare |
$1,021.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,589.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,021.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,052.46
|
|
|
PR RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF
|
Professional
|
Both
|
$3,211.00
|
|
|
Service Code
|
HCPCS 25415
|
| Min. Negotiated Rate |
$272.95 |
| Max. Negotiated Rate |
$2,247.70 |
| Rate for Payer: Aetna Commercial |
$1,280.32
|
| Rate for Payer: Aetna Medicare |
$993.68
|
| Rate for Payer: BCBS Complete |
$655.52
|
| Rate for Payer: BCBS MAPPO |
$955.46
|
| Rate for Payer: BCBS Trust/PPO |
$272.95
|
| Rate for Payer: BCN Commercial |
$1,422.05
|
| Rate for Payer: BCN Medicare Advantage |
$955.46
|
| Rate for Payer: Cash Price |
$2,568.80
|
| Rate for Payer: Cash Price |
$2,568.80
|
| Rate for Payer: Cofinity Commercial |
$1,375.86
|
| Rate for Payer: Cofinity Commercial |
$1,280.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$955.46
|
| Rate for Payer: Mclaren Medicaid |
$624.30
|
| Rate for Payer: Meridian Medicaid |
$655.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,003.23
|
| Rate for Payer: PACE SWMI |
$955.46
|
| Rate for Payer: PHP Medicare Advantage |
$955.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$624.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,486.00
|
| Rate for Payer: Priority Health Medicare |
$955.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,486.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$955.46
|
| Rate for Payer: UHC Medicare Advantage |
$984.12
|
|
|
PR RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT
|
Professional
|
Both
|
$2,581.00
|
|
|
Service Code
|
HCPCS 25400
|
| Min. Negotiated Rate |
$211.32 |
| Max. Negotiated Rate |
$1,806.70 |
| Rate for Payer: Aetna Commercial |
$1,062.79
|
| Rate for Payer: Aetna Medicare |
$824.86
|
| Rate for Payer: BCBS Complete |
$544.59
|
| Rate for Payer: BCBS MAPPO |
$793.13
|
| Rate for Payer: BCBS Trust/PPO |
$211.32
|
| Rate for Payer: BCN Commercial |
$1,182.60
|
| Rate for Payer: BCN Medicare Advantage |
$793.13
|
| Rate for Payer: Cash Price |
$2,064.80
|
| Rate for Payer: Cash Price |
$2,064.80
|
| Rate for Payer: Cofinity Commercial |
$1,142.11
|
| Rate for Payer: Cofinity Commercial |
$1,062.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$793.13
|
| Rate for Payer: Mclaren Medicaid |
$518.66
|
| Rate for Payer: Meridian Medicaid |
$544.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$832.79
|
| Rate for Payer: PACE SWMI |
$793.13
|
| Rate for Payer: PHP Medicare Advantage |
$793.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$518.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,806.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,235.77
|
| Rate for Payer: Priority Health Medicare |
$793.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,235.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$793.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$793.13
|
| Rate for Payer: UHC Medicare Advantage |
$816.92
|
|
|
PR RPR NON-UNION MTCRPL/PHALANX
|
Professional
|
Both
|
$2,068.00
|
|
|
Service Code
|
HCPCS 26546
|
| Min. Negotiated Rate |
$243.55 |
| Max. Negotiated Rate |
$1,608.04 |
| Rate for Payer: Aetna Commercial |
$1,361.49
|
| Rate for Payer: Aetna Medicare |
$1,056.68
|
| Rate for Payer: BCBS Complete |
$704.95
|
| Rate for Payer: BCBS MAPPO |
$1,016.04
|
| Rate for Payer: BCBS Trust/PPO |
$243.55
|
| Rate for Payer: BCN Commercial |
$1,538.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,016.04
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,463.10
|
| Rate for Payer: Cofinity Commercial |
$1,361.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,016.04
|
| Rate for Payer: Mclaren Medicaid |
$671.38
|
| Rate for Payer: Meridian Medicaid |
$704.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,066.84
|
| Rate for Payer: PACE SWMI |
$1,016.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,016.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$671.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,447.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,608.04
|
| Rate for Payer: Priority Health Medicare |
$1,016.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,608.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,016.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,016.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,046.52
|
|
|
PR RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC
|
Professional
|
Both
|
$1,349.00
|
|
|
Service Code
|
HCPCS 25440
|
| Min. Negotiated Rate |
$497.78 |
| Max. Negotiated Rate |
$1,264.75 |
| Rate for Payer: Aetna Commercial |
$1,015.92
|
| Rate for Payer: Aetna Medicare |
$788.48
|
| Rate for Payer: BCBS Complete |
$522.67
|
| Rate for Payer: BCBS MAPPO |
$758.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,264.75
|
| Rate for Payer: BCN Commercial |
$1,131.77
|
| Rate for Payer: BCN Medicare Advantage |
$758.15
|
| Rate for Payer: Cash Price |
$1,079.20
|
| Rate for Payer: Cash Price |
$1,079.20
|
| Rate for Payer: Cofinity Commercial |
$1,091.74
|
| Rate for Payer: Cofinity Commercial |
$1,015.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$758.15
|
| Rate for Payer: Mclaren Medicaid |
$497.78
|
| Rate for Payer: Meridian Medicaid |
$522.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$796.06
|
| Rate for Payer: PACE SWMI |
$758.15
|
| Rate for Payer: PHP Medicare Advantage |
$758.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$944.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,182.67
|
| Rate for Payer: Priority Health Medicare |
$758.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,182.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$758.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$758.15
|
| Rate for Payer: UHC Medicare Advantage |
$780.89
|
|
|
PR RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT
|
Professional
|
Both
|
$411.23
|
|
|
Service Code
|
HCPCS 30468
|
| Min. Negotiated Rate |
$107.78 |
| Max. Negotiated Rate |
$3,788.72 |
| Rate for Payer: Aetna Commercial |
$223.22
|
| Rate for Payer: Aetna Medicare |
$173.24
|
| Rate for Payer: BCBS Complete |
$113.17
|
| Rate for Payer: BCBS MAPPO |
$166.58
|
| Rate for Payer: BCBS Trust/PPO |
$627.09
|
| Rate for Payer: BCN Commercial |
$3,788.72
|
| Rate for Payer: BCN Medicare Advantage |
$166.58
|
| Rate for Payer: Cash Price |
$328.98
|
| Rate for Payer: Cash Price |
$328.98
|
| Rate for Payer: Cofinity Commercial |
$239.88
|
| Rate for Payer: Cofinity Commercial |
$223.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.58
|
| Rate for Payer: Mclaren Medicaid |
$107.78
|
| Rate for Payer: Meridian Medicaid |
$113.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.91
|
| Rate for Payer: PACE SWMI |
$166.58
|
| Rate for Payer: PHP Medicare Advantage |
$166.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.84
|
| Rate for Payer: Priority Health Medicare |
$166.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.58
|
| Rate for Payer: UHC Medicare Advantage |
$171.58
|
|
|
PR RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH
|
Professional
|
Both
|
$2,672.00
|
|
|
Service Code
|
HCPCS 43336
|
| Min. Negotiated Rate |
$912.49 |
| Max. Negotiated Rate |
$2,508.89 |
| Rate for Payer: Aetna Commercial |
$1,915.91
|
| Rate for Payer: Aetna Medicare |
$1,486.97
|
| Rate for Payer: BCBS Complete |
$958.11
|
| Rate for Payer: BCBS MAPPO |
$1,429.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,143.04
|
| Rate for Payer: BCN Commercial |
$2,085.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,429.78
|
| Rate for Payer: Cash Price |
$2,137.60
|
| Rate for Payer: Cash Price |
$2,137.60
|
| Rate for Payer: Cofinity Commercial |
$1,915.91
|
| Rate for Payer: Cofinity Commercial |
$2,058.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,429.78
|
| Rate for Payer: Mclaren Medicaid |
$912.49
|
| Rate for Payer: Meridian Medicaid |
$958.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,501.27
|
| Rate for Payer: PACE SWMI |
$1,429.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,429.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$912.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,870.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,508.89
|
| Rate for Payer: Priority Health Medicare |
$1,429.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,508.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,429.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,429.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,472.67
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH
|
Professional
|
Both
|
$2,076.00
|
|
|
Service Code
|
HCPCS 43332
|
| Min. Negotiated Rate |
$732.08 |
| Max. Negotiated Rate |
$2,006.75 |
| Rate for Payer: Aetna Commercial |
$1,526.68
|
| Rate for Payer: Aetna Medicare |
$1,184.88
|
| Rate for Payer: BCBS Complete |
$768.68
|
| Rate for Payer: BCBS MAPPO |
$1,139.31
|
| Rate for Payer: BCBS Trust/PPO |
$822.56
|
| Rate for Payer: BCN Commercial |
$1,667.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,139.31
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cofinity Commercial |
$1,640.61
|
| Rate for Payer: Cofinity Commercial |
$1,526.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,139.31
|
| Rate for Payer: Mclaren Medicaid |
$732.08
|
| Rate for Payer: Meridian Medicaid |
$768.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,196.28
|
| Rate for Payer: PACE SWMI |
$1,139.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,139.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$732.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,453.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.75
|
| Rate for Payer: Priority Health Medicare |
$1,139.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,006.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,139.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,139.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,173.49
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH
|
Professional
|
Both
|
$2,746.00
|
|
|
Service Code
|
HCPCS 43335
|
| Min. Negotiated Rate |
$840.07 |
| Max. Negotiated Rate |
$2,308.97 |
| Rate for Payer: Aetna Commercial |
$1,764.53
|
| Rate for Payer: Aetna Medicare |
$1,369.48
|
| Rate for Payer: BCBS Complete |
$882.07
|
| Rate for Payer: BCBS MAPPO |
$1,316.81
|
| Rate for Payer: BCBS Trust/PPO |
$871.97
|
| Rate for Payer: BCN Commercial |
$1,919.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,316.81
|
| Rate for Payer: Cash Price |
$2,196.80
|
| Rate for Payer: Cash Price |
$2,196.80
|
| Rate for Payer: Cofinity Commercial |
$1,764.53
|
| Rate for Payer: Cofinity Commercial |
$1,896.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,316.81
|
| Rate for Payer: Mclaren Medicaid |
$840.07
|
| Rate for Payer: Meridian Medicaid |
$882.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,382.65
|
| Rate for Payer: PACE SWMI |
$1,316.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,316.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,922.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,308.97
|
| Rate for Payer: Priority Health Medicare |
$1,316.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,308.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,316.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,316.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,356.31
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH
|
Professional
|
Both
|
$3,372.00
|
|
|
Service Code
|
HCPCS 43334
|
| Min. Negotiated Rate |
$782.14 |
| Max. Negotiated Rate |
$2,360.40 |
| Rate for Payer: Aetna Commercial |
$1,643.83
|
| Rate for Payer: Aetna Medicare |
$1,275.81
|
| Rate for Payer: BCBS Complete |
$821.25
|
| Rate for Payer: BCBS MAPPO |
$1,226.74
|
| Rate for Payer: BCBS Trust/PPO |
$940.03
|
| Rate for Payer: BCN Commercial |
$1,789.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,226.74
|
| Rate for Payer: Cash Price |
$2,697.60
|
| Rate for Payer: Cash Price |
$2,697.60
|
| Rate for Payer: Cofinity Commercial |
$1,643.83
|
| Rate for Payer: Cofinity Commercial |
$1,766.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,226.74
|
| Rate for Payer: Mclaren Medicaid |
$782.14
|
| Rate for Payer: Meridian Medicaid |
$821.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,288.08
|
| Rate for Payer: PACE SWMI |
$1,226.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,226.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$782.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,360.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,153.16
|
| Rate for Payer: Priority Health Medicare |
$1,226.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,153.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,226.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,226.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,263.54
|
|
