PR RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE
|
Professional
|
Both
|
$1,932.00
|
|
Service Code
|
HCPCS 49600
|
Min. Negotiated Rate |
$472.43 |
Max. Negotiated Rate |
$2,035.01 |
Rate for Payer: Aetna Commercial |
$980.48
|
Rate for Payer: Aetna Medicare |
$760.97
|
Rate for Payer: BCBS Complete |
$496.05
|
Rate for Payer: BCBS MAPPO |
$731.70
|
Rate for Payer: BCBS Trust/PPO |
$2,035.01
|
Rate for Payer: BCN Commercial |
$1,077.53
|
Rate for Payer: BCN Medicare Advantage |
$731.70
|
Rate for Payer: Cash Price |
$1,545.60
|
Rate for Payer: Cash Price |
$1,545.60
|
Rate for Payer: Cofinity Commercial |
$1,053.65
|
Rate for Payer: Cofinity Commercial |
$980.48
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.70
|
Rate for Payer: Mclaren Medicaid |
$472.43
|
Rate for Payer: Meridian Medicaid |
$496.05
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$768.28
|
Rate for Payer: PACE SWMI |
$731.70
|
Rate for Payer: PHP Medicare Advantage |
$731.70
|
Rate for Payer: Priority Health Choice Medicaid |
$472.43
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,352.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,296.48
|
Rate for Payer: Priority Health Medicare |
$731.70
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,296.48
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$731.70
|
Rate for Payer: UHC Dual Complete DSNP |
$731.70
|
Rate for Payer: UHC Medicare Advantage |
$753.65
|
|
PR RPR SPIGELIAN HERNIA
|
Professional
|
Both
|
$1,594.00
|
|
Service Code
|
HCPCS 49590
|
Min. Negotiated Rate |
$637.60 |
Max. Negotiated Rate |
$1,115.80 |
Rate for Payer: BCBS Complete |
$637.60
|
Rate for Payer: Cash Price |
$1,275.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,115.80
|
|
PR RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL
|
Professional
|
Both
|
$7,731.00
|
|
Service Code
|
HCPCS 38780
|
Min. Negotiated Rate |
$672.02 |
Max. Negotiated Rate |
$5,411.70 |
Rate for Payer: Aetna Commercial |
$1,375.91
|
Rate for Payer: Aetna Medicare |
$1,067.87
|
Rate for Payer: BCBS Complete |
$705.62
|
Rate for Payer: BCBS MAPPO |
$1,026.80
|
Rate for Payer: BCBS Trust/PPO |
$957.28
|
Rate for Payer: BCN Commercial |
$1,513.44
|
Rate for Payer: BCN Medicare Advantage |
$1,026.80
|
Rate for Payer: Cash Price |
$6,184.80
|
Rate for Payer: Cash Price |
$6,184.80
|
Rate for Payer: Cofinity Commercial |
$1,478.59
|
Rate for Payer: Cofinity Commercial |
$1,375.91
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,026.80
|
Rate for Payer: Mclaren Medicaid |
$672.02
|
Rate for Payer: Meridian Medicaid |
$705.62
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,078.14
|
Rate for Payer: PACE SWMI |
$1,026.80
|
Rate for Payer: PHP Medicare Advantage |
$1,026.80
|
Rate for Payer: Priority Health Choice Medicaid |
$672.02
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,411.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,243.29
|
Rate for Payer: Priority Health Medicare |
$1,026.80
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,243.29
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,026.80
|
Rate for Payer: UHC Dual Complete DSNP |
$1,026.80
|
Rate for Payer: UHC Medicare Advantage |
$1,057.60
|
|
PR RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON
|
Professional
|
Both
|
$1,228.00
|
|
Service Code
|
HCPCS 28200
|
Min. Negotiated Rate |
$211.08 |
Max. Negotiated Rate |
$1,084.07 |
Rate for Payer: Aetna Commercial |
$427.37
|
Rate for Payer: Aetna Medicare |
$331.69
|
Rate for Payer: BCBS Complete |
$221.63
|
Rate for Payer: BCBS MAPPO |
$318.93
|
Rate for Payer: BCBS Trust/PPO |
$1,084.07
|
Rate for Payer: BCN Commercial |
$719.83
|
Rate for Payer: BCN Medicare Advantage |
$318.93
|
Rate for Payer: Cash Price |
$982.40
|
Rate for Payer: Cash Price |
$982.40
|
Rate for Payer: Cofinity Commercial |
$459.26
|
Rate for Payer: Cofinity Commercial |
$427.37
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.93
|
Rate for Payer: Mclaren Medicaid |
$211.08
|
Rate for Payer: Meridian Medicaid |
$221.63
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$334.88
|
Rate for Payer: PACE SWMI |
$318.93
|
Rate for Payer: PHP Medicare Advantage |
$318.93
|
Rate for Payer: Priority Health Choice Medicaid |
$211.08
|
Rate for Payer: Priority Health Cigna Priority Health |
$859.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.91
|
Rate for Payer: Priority Health Medicare |
$318.93
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$498.91
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$318.93
|
Rate for Payer: UHC Dual Complete DSNP |
$318.93
|
Rate for Payer: UHC Medicare Advantage |
$328.50
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS
|
Professional
|
Both
|
$1,229.00
|
|
Service Code
|
HCPCS 25263
|
Min. Negotiated Rate |
$413.22 |
Max. Negotiated Rate |
$3,601.42 |
Rate for Payer: Aetna Commercial |
$838.81
|
Rate for Payer: Aetna Medicare |
$651.02
|
Rate for Payer: BCBS Complete |
$433.88
|
Rate for Payer: BCBS MAPPO |
$625.98
|
Rate for Payer: BCBS Trust/PPO |
$3,601.42
|
Rate for Payer: BCN Commercial |
$938.26
|
Rate for Payer: BCN Medicare Advantage |
$625.98
|
Rate for Payer: Cash Price |
$983.20
|
Rate for Payer: Cash Price |
$983.20
|
Rate for Payer: Cofinity Commercial |
$901.41
|
Rate for Payer: Cofinity Commercial |
$838.81
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.98
|
Rate for Payer: Mclaren Medicaid |
$413.22
|
Rate for Payer: Meridian Medicaid |
$433.88
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$657.28
|
Rate for Payer: PACE SWMI |
$625.98
|
Rate for Payer: PHP Medicare Advantage |
$625.98
|
Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
Rate for Payer: Priority Health Cigna Priority Health |
$860.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$980.44
|
Rate for Payer: Priority Health Medicare |
$625.98
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$980.44
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$625.98
|
Rate for Payer: UHC Dual Complete DSNP |
$625.98
|
Rate for Payer: UHC Medicare Advantage |
$644.76
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU
|
Professional
|
Both
|
$1,668.00
|
|
Service Code
|
HCPCS 25260
|
Min. Negotiated Rate |
$413.22 |
Max. Negotiated Rate |
$1,459.69 |
Rate for Payer: Aetna Commercial |
$839.87
|
Rate for Payer: Aetna Medicare |
$651.84
|
Rate for Payer: BCBS Complete |
$433.88
|
Rate for Payer: BCBS MAPPO |
$626.77
|
Rate for Payer: BCBS Trust/PPO |
$1,459.69
|
Rate for Payer: BCN Commercial |
$940.22
|
Rate for Payer: BCN Medicare Advantage |
$626.77
|
Rate for Payer: Cash Price |
$1,334.40
|
Rate for Payer: Cash Price |
$1,334.40
|
Rate for Payer: Cofinity Commercial |
$839.87
|
Rate for Payer: Cofinity Commercial |
$902.55
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.77
|
Rate for Payer: Mclaren Medicaid |
$413.22
|
Rate for Payer: Meridian Medicaid |
$433.88
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$658.11
|
Rate for Payer: PACE SWMI |
$626.77
|
Rate for Payer: PHP Medicare Advantage |
$626.77
|
Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,167.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$982.49
|
Rate for Payer: Priority Health Medicare |
$626.77
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$982.49
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$626.77
|
Rate for Payer: UHC Dual Complete DSNP |
$626.77
|
Rate for Payer: UHC Medicare Advantage |
$645.57
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN
|
Professional
|
Both
|
$1,390.00
|
|
Service Code
|
HCPCS 25270
|
Min. Negotiated Rate |
$322.91 |
Max. Negotiated Rate |
$3,579.76 |
Rate for Payer: Aetna Commercial |
$653.99
|
Rate for Payer: Aetna Medicare |
$507.57
|
Rate for Payer: BCBS Complete |
$339.06
|
Rate for Payer: BCBS MAPPO |
$488.05
|
Rate for Payer: BCBS Trust/PPO |
$3,579.76
|
Rate for Payer: BCN Commercial |
$733.02
|
Rate for Payer: BCN Medicare Advantage |
$488.05
|
Rate for Payer: Cash Price |
$1,112.00
|
Rate for Payer: Cash Price |
$1,112.00
|
Rate for Payer: Cofinity Commercial |
$702.79
|
Rate for Payer: Cofinity Commercial |
$653.99
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.05
|
Rate for Payer: Mclaren Medicaid |
$322.91
|
Rate for Payer: Meridian Medicaid |
$339.06
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$512.45
|
Rate for Payer: PACE SWMI |
$488.05
|
Rate for Payer: PHP Medicare Advantage |
$488.05
|
Rate for Payer: Priority Health Choice Medicaid |
$322.91
|
Rate for Payer: Priority Health Cigna Priority Health |
$973.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.98
|
Rate for Payer: Priority Health Medicare |
$488.05
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$765.98
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$488.05
|
Rate for Payer: UHC Dual Complete DSNP |
$488.05
|
Rate for Payer: UHC Medicare Advantage |
$502.69
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU
|
Professional
|
Both
|
$1,589.00
|
|
Service Code
|
HCPCS 25272
|
Min. Negotiated Rate |
$365.30 |
Max. Negotiated Rate |
$3,566.55 |
Rate for Payer: Aetna Commercial |
$742.01
|
Rate for Payer: Aetna Medicare |
$575.89
|
Rate for Payer: BCBS Complete |
$383.56
|
Rate for Payer: BCBS MAPPO |
$553.74
|
Rate for Payer: BCBS Trust/PPO |
$3,566.55
|
Rate for Payer: BCN Commercial |
$829.29
|
Rate for Payer: BCN Medicare Advantage |
$553.74
|
Rate for Payer: Cash Price |
$1,271.20
|
Rate for Payer: Cash Price |
$1,271.20
|
Rate for Payer: Cofinity Commercial |
$797.39
|
Rate for Payer: Cofinity Commercial |
$742.01
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$553.74
|
Rate for Payer: Mclaren Medicaid |
$365.30
|
Rate for Payer: Meridian Medicaid |
$383.56
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$581.43
|
Rate for Payer: PACE SWMI |
$553.74
|
Rate for Payer: PHP Medicare Advantage |
$553.74
|
Rate for Payer: Priority Health Choice Medicaid |
$365.30
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,112.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.58
|
Rate for Payer: Priority Health Medicare |
$553.74
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$866.58
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$553.74
|
Rate for Payer: UHC Dual Complete DSNP |
$553.74
|
Rate for Payer: UHC Medicare Advantage |
$570.35
|
|
PR RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT
|
Professional
|
Both
|
$1,985.00
|
|
Service Code
|
HCPCS 25275
|
Min. Negotiated Rate |
$436.86 |
Max. Negotiated Rate |
$1,389.50 |
Rate for Payer: Aetna Commercial |
$889.30
|
Rate for Payer: Aetna Medicare |
$690.21
|
Rate for Payer: BCBS Complete |
$458.70
|
Rate for Payer: BCBS MAPPO |
$663.66
|
Rate for Payer: BCBS Trust/PPO |
$1,102.56
|
Rate for Payer: BCN Commercial |
$993.00
|
Rate for Payer: BCN Medicare Advantage |
$663.66
|
Rate for Payer: Cash Price |
$1,588.00
|
Rate for Payer: Cash Price |
$1,588.00
|
Rate for Payer: Cofinity Commercial |
$955.67
|
Rate for Payer: Cofinity Commercial |
$889.30
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.66
|
Rate for Payer: Mclaren Medicaid |
$436.86
|
Rate for Payer: Meridian Medicaid |
$458.70
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$696.84
|
Rate for Payer: PACE SWMI |
$663.66
|
Rate for Payer: PHP Medicare Advantage |
$663.66
|
Rate for Payer: Priority Health Choice Medicaid |
$436.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,389.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,037.64
|
Rate for Payer: Priority Health Medicare |
$663.66
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,037.64
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$663.66
|
Rate for Payer: UHC Dual Complete DSNP |
$663.66
|
Rate for Payer: UHC Medicare Advantage |
$683.57
|
|
PR RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON
|
Professional
|
Both
|
$928.00
|
|
Service Code
|
HCPCS 28210
|
Min. Negotiated Rate |
$273.49 |
Max. Negotiated Rate |
$912.90 |
Rate for Payer: Aetna Commercial |
$557.75
|
Rate for Payer: Aetna Medicare |
$432.88
|
Rate for Payer: BCBS Complete |
$287.16
|
Rate for Payer: BCBS MAPPO |
$416.23
|
Rate for Payer: BCBS Trust/PPO |
$912.90
|
Rate for Payer: BCN Commercial |
$867.89
|
Rate for Payer: BCN Medicare Advantage |
$416.23
|
Rate for Payer: Cash Price |
$742.40
|
Rate for Payer: Cash Price |
$742.40
|
Rate for Payer: Cofinity Commercial |
$599.37
|
Rate for Payer: Cofinity Commercial |
$557.75
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.23
|
Rate for Payer: Mclaren Medicaid |
$273.49
|
Rate for Payer: Meridian Medicaid |
$287.16
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.04
|
Rate for Payer: PACE SWMI |
$416.23
|
Rate for Payer: PHP Medicare Advantage |
$416.23
|
Rate for Payer: Priority Health Choice Medicaid |
$273.49
|
Rate for Payer: Priority Health Cigna Priority Health |
$649.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$649.04
|
Rate for Payer: Priority Health Medicare |
$416.23
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$649.04
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$416.23
|
Rate for Payer: UHC Dual Complete DSNP |
$416.23
|
Rate for Payer: UHC Medicare Advantage |
$428.72
|
|
PR RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS
|
Professional
|
Both
|
$8,520.00
|
|
Service Code
|
HCPCS 33877
|
Min. Negotiated Rate |
$2,114.78 |
Max. Negotiated Rate |
$5,964.00 |
Rate for Payer: Aetna Commercial |
$4,758.26
|
Rate for Payer: Aetna Medicare |
$3,692.98
|
Rate for Payer: BCBS Complete |
$2,362.42
|
Rate for Payer: BCBS MAPPO |
$3,550.94
|
Rate for Payer: BCBS Trust/PPO |
$2,114.78
|
Rate for Payer: BCN Commercial |
$5,146.27
|
Rate for Payer: BCN Medicare Advantage |
$3,550.94
|
Rate for Payer: Cash Price |
$6,816.00
|
Rate for Payer: Cash Price |
$6,816.00
|
Rate for Payer: Cofinity Commercial |
$4,758.26
|
Rate for Payer: Cofinity Commercial |
$5,113.35
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,550.94
|
Rate for Payer: Mclaren Medicaid |
$2,249.92
|
Rate for Payer: Meridian Medicaid |
$2,362.42
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,728.49
|
Rate for Payer: PACE SWMI |
$3,550.94
|
Rate for Payer: PHP Medicare Advantage |
$3,550.94
|
Rate for Payer: Priority Health Choice Medicaid |
$2,249.92
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,964.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,602.04
|
Rate for Payer: Priority Health Medicare |
$3,550.94
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$5,602.04
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3,550.94
|
Rate for Payer: UHC Dual Complete DSNP |
$3,550.94
|
Rate for Payer: UHC Medicare Advantage |
$3,657.47
|
|
PR RPR/TRAUMATIC AV FISTULA EXTREMITIES
|
Professional
|
Both
|
$1,511.00
|
|
Service Code
|
HCPCS 35190
|
Min. Negotiated Rate |
$474.78 |
Max. Negotiated Rate |
$1,192.11 |
Rate for Payer: Aetna Commercial |
$1,005.63
|
Rate for Payer: Aetna Medicare |
$780.49
|
Rate for Payer: BCBS Complete |
$498.52
|
Rate for Payer: BCBS MAPPO |
$750.47
|
Rate for Payer: BCBS Trust/PPO |
$706.87
|
Rate for Payer: BCN Commercial |
$1,095.13
|
Rate for Payer: BCN Medicare Advantage |
$750.47
|
Rate for Payer: Cash Price |
$1,208.80
|
Rate for Payer: Cash Price |
$1,208.80
|
Rate for Payer: Cofinity Commercial |
$1,080.68
|
Rate for Payer: Cofinity Commercial |
$1,005.63
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$750.47
|
Rate for Payer: Mclaren Medicaid |
$474.78
|
Rate for Payer: Meridian Medicaid |
$498.52
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$787.99
|
Rate for Payer: PACE SWMI |
$750.47
|
Rate for Payer: PHP Medicare Advantage |
$750.47
|
Rate for Payer: Priority Health Choice Medicaid |
$474.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,057.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,192.11
|
Rate for Payer: Priority Health Medicare |
$750.47
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,192.11
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$750.47
|
Rate for Payer: UHC Dual Complete DSNP |
$750.47
|
Rate for Payer: UHC Medicare Advantage |
$772.98
|
|
PR RPR/TRAUMATIC AV FISTULA HEAD & NECK
|
Professional
|
Both
|
$4,157.00
|
|
Service Code
|
HCPCS 35188
|
Min. Negotiated Rate |
$833.26 |
Max. Negotiated Rate |
$2,909.90 |
Rate for Payer: Aetna Commercial |
$1,729.86
|
Rate for Payer: Aetna Medicare |
$1,342.58
|
Rate for Payer: BCBS Complete |
$874.92
|
Rate for Payer: BCBS MAPPO |
$1,290.94
|
Rate for Payer: BCBS Trust/PPO |
$933.51
|
Rate for Payer: BCN Commercial |
$1,893.13
|
Rate for Payer: BCN Medicare Advantage |
$1,290.94
|
Rate for Payer: Cash Price |
$3,325.60
|
Rate for Payer: Cash Price |
$3,325.60
|
Rate for Payer: Cofinity Commercial |
$1,858.95
|
Rate for Payer: Cofinity Commercial |
$1,729.86
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,290.94
|
Rate for Payer: Mclaren Medicaid |
$833.26
|
Rate for Payer: Meridian Medicaid |
$874.92
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,355.49
|
Rate for Payer: PACE SWMI |
$1,290.94
|
Rate for Payer: PHP Medicare Advantage |
$1,290.94
|
Rate for Payer: Priority Health Choice Medicaid |
$833.26
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,909.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,060.80
|
Rate for Payer: Priority Health Medicare |
$1,290.94
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,060.80
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,290.94
|
Rate for Payer: UHC Dual Complete DSNP |
$1,290.94
|
Rate for Payer: UHC Medicare Advantage |
$1,329.67
|
|
PR RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE
|
Professional
|
Both
|
$618.00
|
|
Service Code
|
HCPCS 55060
|
Min. Negotiated Rate |
$243.67 |
Max. Negotiated Rate |
$1,220.90 |
Rate for Payer: Aetna Commercial |
$497.10
|
Rate for Payer: Aetna Medicare |
$385.81
|
Rate for Payer: BCBS Complete |
$255.85
|
Rate for Payer: BCBS MAPPO |
$370.97
|
Rate for Payer: BCBS Trust/PPO |
$1,220.90
|
Rate for Payer: BCN Commercial |
$551.23
|
Rate for Payer: BCN Medicare Advantage |
$370.97
|
Rate for Payer: Cash Price |
$494.40
|
Rate for Payer: Cash Price |
$494.40
|
Rate for Payer: Cofinity Commercial |
$497.10
|
Rate for Payer: Cofinity Commercial |
$534.20
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.97
|
Rate for Payer: Mclaren Medicaid |
$243.67
|
Rate for Payer: Meridian Medicaid |
$255.85
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$389.52
|
Rate for Payer: PACE SWMI |
$370.97
|
Rate for Payer: PHP Medicare Advantage |
$370.97
|
Rate for Payer: Priority Health Choice Medicaid |
$243.67
|
Rate for Payer: Priority Health Cigna Priority Health |
$432.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.53
|
Rate for Payer: Priority Health Medicare |
$370.97
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$609.53
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$370.97
|
Rate for Payer: UHC Dual Complete DSNP |
$370.97
|
Rate for Payer: UHC Medicare Advantage |
$382.10
|
|
PR RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$439.00
|
|
Service Code
|
HCPCS 36575
|
Min. Negotiated Rate |
$20.87 |
Max. Negotiated Rate |
$1,177.58 |
Rate for Payer: Aetna Commercial |
$43.78
|
Rate for Payer: Aetna Medicare |
$33.98
|
Rate for Payer: BCBS Complete |
$21.91
|
Rate for Payer: BCBS MAPPO |
$32.67
|
Rate for Payer: BCBS Trust/PPO |
$1,177.58
|
Rate for Payer: BCN Commercial |
$212.57
|
Rate for Payer: BCN Medicare Advantage |
$32.67
|
Rate for Payer: Cash Price |
$351.20
|
Rate for Payer: Cash Price |
$351.20
|
Rate for Payer: Cofinity Commercial |
$47.04
|
Rate for Payer: Cofinity Commercial |
$43.78
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.67
|
Rate for Payer: Mclaren Medicaid |
$20.87
|
Rate for Payer: Meridian Medicaid |
$21.91
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.30
|
Rate for Payer: PACE SWMI |
$32.67
|
Rate for Payer: PHP Medicare Advantage |
$32.67
|
Rate for Payer: Priority Health Choice Medicaid |
$20.87
|
Rate for Payer: Priority Health Cigna Priority Health |
$307.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.13
|
Rate for Payer: Priority Health Medicare |
$32.67
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$52.13
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$32.67
|
Rate for Payer: UHC Dual Complete DSNP |
$32.67
|
Rate for Payer: UHC Medicare Advantage |
$33.65
|
|
PR RPR UMBILICAL HERNIA < 5 YRS INCARCERATED
|
Professional
|
Both
|
$1,434.00
|
|
Service Code
|
HCPCS 49582
|
Min. Negotiated Rate |
$573.60 |
Max. Negotiated Rate |
$1,003.80 |
Rate for Payer: BCBS Complete |
$573.60
|
Rate for Payer: Cash Price |
$1,147.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,003.80
|
|
PR RPR UMBILICAL HERNIA < 5 YRS REDUCIBLE
|
Professional
|
Both
|
$1,243.00
|
|
Service Code
|
HCPCS 49580
|
Min. Negotiated Rate |
$497.20 |
Max. Negotiated Rate |
$870.10 |
Rate for Payer: BCBS Complete |
$497.20
|
Rate for Payer: Cash Price |
$994.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$870.10
|
|
PR RPR UMBILICAL HERNIA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,652.00
|
|
Service Code
|
HCPCS 49587
|
Min. Negotiated Rate |
$660.80 |
Max. Negotiated Rate |
$1,156.40 |
Rate for Payer: BCBS Complete |
$660.80
|
Rate for Payer: Cash Price |
$1,321.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,156.40
|
|
PR RPR UMBILICAL HRNA 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,434.00
|
|
Service Code
|
HCPCS 49585
|
Min. Negotiated Rate |
$573.60 |
Max. Negotiated Rate |
$1,003.80 |
Rate for Payer: BCBS Complete |
$573.60
|
Rate for Payer: Cash Price |
$1,147.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,003.80
|
|
PR RPR VENTR O/F TRC OBSTRCJ PATCH ENLGMENT O/F TRC
|
Professional
|
Both
|
$7,883.00
|
|
Service Code
|
HCPCS 33414
|
Min. Negotiated Rate |
$509.28 |
Max. Negotiated Rate |
$5,518.10 |
Rate for Payer: Aetna Commercial |
$2,834.07
|
Rate for Payer: Aetna Medicare |
$2,199.58
|
Rate for Payer: BCBS Complete |
$1,413.69
|
Rate for Payer: BCBS MAPPO |
$2,114.98
|
Rate for Payer: BCBS Trust/PPO |
$509.28
|
Rate for Payer: BCN Commercial |
$3,076.23
|
Rate for Payer: BCN Medicare Advantage |
$2,114.98
|
Rate for Payer: Cash Price |
$6,306.40
|
Rate for Payer: Cash Price |
$6,306.40
|
Rate for Payer: Cofinity Commercial |
$2,834.07
|
Rate for Payer: Cofinity Commercial |
$3,045.57
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,114.98
|
Rate for Payer: Mclaren Medicaid |
$1,346.37
|
Rate for Payer: Meridian Medicaid |
$1,413.69
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,220.73
|
Rate for Payer: PACE SWMI |
$2,114.98
|
Rate for Payer: PHP Medicare Advantage |
$2,114.98
|
Rate for Payer: Priority Health Choice Medicaid |
$1,346.37
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,518.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,348.67
|
Rate for Payer: Priority Health Medicare |
$2,114.98
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3,348.67
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2,114.98
|
Rate for Payer: UHC Dual Complete DSNP |
$2,114.98
|
Rate for Payer: UHC Medicare Advantage |
$2,178.43
|
|
PR RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER
|
Professional
|
Both
|
$2,768.00
|
|
Service Code
|
HCPCS 26428
|
Min. Negotiated Rate |
$98.26 |
Max. Negotiated Rate |
$1,937.60 |
Rate for Payer: Aetna Commercial |
$1,045.13
|
Rate for Payer: Aetna Medicare |
$811.15
|
Rate for Payer: BCBS Complete |
$541.68
|
Rate for Payer: BCBS MAPPO |
$779.95
|
Rate for Payer: BCBS Trust/PPO |
$98.26
|
Rate for Payer: BCN Commercial |
$1,186.02
|
Rate for Payer: BCN Medicare Advantage |
$779.95
|
Rate for Payer: Cash Price |
$2,214.40
|
Rate for Payer: Cash Price |
$2,214.40
|
Rate for Payer: Cofinity Commercial |
$1,045.13
|
Rate for Payer: Cofinity Commercial |
$1,123.13
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.95
|
Rate for Payer: Mclaren Medicaid |
$515.89
|
Rate for Payer: Meridian Medicaid |
$541.68
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$818.95
|
Rate for Payer: PACE SWMI |
$779.95
|
Rate for Payer: PHP Medicare Advantage |
$779.95
|
Rate for Payer: Priority Health Choice Medicaid |
$515.89
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,937.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.34
|
Rate for Payer: Priority Health Medicare |
$779.95
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,239.34
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$779.95
|
Rate for Payer: UHC Dual Complete DSNP |
$779.95
|
Rate for Payer: UHC Medicare Advantage |
$803.35
|
|
PR RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR
|
Professional
|
Both
|
$1,944.00
|
|
Service Code
|
HCPCS 26426
|
Min. Negotiated Rate |
$195.47 |
Max. Negotiated Rate |
$1,360.80 |
Rate for Payer: Aetna Commercial |
$666.89
|
Rate for Payer: Aetna Medicare |
$517.59
|
Rate for Payer: BCBS Complete |
$345.54
|
Rate for Payer: BCBS MAPPO |
$497.68
|
Rate for Payer: BCBS Trust/PPO |
$195.47
|
Rate for Payer: BCN Commercial |
$747.19
|
Rate for Payer: BCN Medicare Advantage |
$497.68
|
Rate for Payer: Cash Price |
$1,555.20
|
Rate for Payer: Cash Price |
$1,555.20
|
Rate for Payer: Cofinity Commercial |
$716.66
|
Rate for Payer: Cofinity Commercial |
$666.89
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$497.68
|
Rate for Payer: Mclaren Medicaid |
$329.09
|
Rate for Payer: Meridian Medicaid |
$345.54
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$522.56
|
Rate for Payer: PACE SWMI |
$497.68
|
Rate for Payer: PHP Medicare Advantage |
$497.68
|
Rate for Payer: Priority Health Choice Medicaid |
$329.09
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,360.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$780.79
|
Rate for Payer: Priority Health Medicare |
$497.68
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$780.79
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$497.68
|
Rate for Payer: UHC Dual Complete DSNP |
$497.68
|
Rate for Payer: UHC Medicare Advantage |
$512.61
|
|
PR RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD
|
Professional
|
Both
|
$1,272.00
|
|
Service Code
|
HCPCS 33226
|
Min. Negotiated Rate |
$305.66 |
Max. Negotiated Rate |
$1,099.92 |
Rate for Payer: Aetna Commercial |
$644.33
|
Rate for Payer: Aetna Medicare |
$500.07
|
Rate for Payer: BCBS Complete |
$320.94
|
Rate for Payer: BCBS MAPPO |
$480.84
|
Rate for Payer: BCBS Trust/PPO |
$1,099.92
|
Rate for Payer: BCN Commercial |
$702.72
|
Rate for Payer: BCN Medicare Advantage |
$480.84
|
Rate for Payer: Cash Price |
$1,017.60
|
Rate for Payer: Cash Price |
$1,017.60
|
Rate for Payer: Cofinity Commercial |
$692.41
|
Rate for Payer: Cofinity Commercial |
$644.33
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.84
|
Rate for Payer: Mclaren Medicaid |
$305.66
|
Rate for Payer: Meridian Medicaid |
$320.94
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.88
|
Rate for Payer: PACE SWMI |
$480.84
|
Rate for Payer: PHP Medicare Advantage |
$480.84
|
Rate for Payer: Priority Health Choice Medicaid |
$305.66
|
Rate for Payer: Priority Health Cigna Priority Health |
$890.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$764.96
|
Rate for Payer: Priority Health Medicare |
$480.84
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$764.96
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$480.84
|
Rate for Payer: UHC Dual Complete DSNP |
$480.84
|
Rate for Payer: UHC Medicare Advantage |
$495.27
|
|
PR RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE
|
Professional
|
Both
|
$1,009.00
|
|
Service Code
|
HCPCS 33215
|
Min. Negotiated Rate |
$195.32 |
Max. Negotiated Rate |
$1,453.88 |
Rate for Payer: Aetna Commercial |
$407.95
|
Rate for Payer: Aetna Medicare |
$316.62
|
Rate for Payer: BCBS Complete |
$205.09
|
Rate for Payer: BCBS MAPPO |
$304.44
|
Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
Rate for Payer: BCN Commercial |
$448.61
|
Rate for Payer: BCN Medicare Advantage |
$304.44
|
Rate for Payer: Cash Price |
$807.20
|
Rate for Payer: Cash Price |
$807.20
|
Rate for Payer: Cofinity Commercial |
$438.39
|
Rate for Payer: Cofinity Commercial |
$407.95
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.44
|
Rate for Payer: Mclaren Medicaid |
$195.32
|
Rate for Payer: Meridian Medicaid |
$205.09
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$319.66
|
Rate for Payer: PACE SWMI |
$304.44
|
Rate for Payer: PHP Medicare Advantage |
$304.44
|
Rate for Payer: Priority Health Choice Medicaid |
$195.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$706.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$488.33
|
Rate for Payer: Priority Health Medicare |
$304.44
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$488.33
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$304.44
|
Rate for Payer: UHC Dual Complete DSNP |
$304.44
|
Rate for Payer: UHC Medicare Advantage |
$313.57
|
|
PR RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE
|
Professional
|
Both
|
$310.00
|
|
Service Code
|
HCPCS 36597
|
Min. Negotiated Rate |
$37.49 |
Max. Negotiated Rate |
$578.49 |
Rate for Payer: Aetna Commercial |
$80.21
|
Rate for Payer: Aetna Medicare |
$62.25
|
Rate for Payer: BCBS Complete |
$39.36
|
Rate for Payer: BCBS MAPPO |
$59.86
|
Rate for Payer: BCBS Trust/PPO |
$578.49
|
Rate for Payer: BCN Commercial |
$163.71
|
Rate for Payer: BCN Medicare Advantage |
$59.86
|
Rate for Payer: Cash Price |
$248.00
|
Rate for Payer: Cash Price |
$248.00
|
Rate for Payer: Cofinity Commercial |
$86.20
|
Rate for Payer: Cofinity Commercial |
$80.21
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.86
|
Rate for Payer: Mclaren Medicaid |
$37.49
|
Rate for Payer: Meridian Medicaid |
$39.36
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.85
|
Rate for Payer: PACE SWMI |
$59.86
|
Rate for Payer: PHP Medicare Advantage |
$59.86
|
Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
Rate for Payer: Priority Health Cigna Priority Health |
$217.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.22
|
Rate for Payer: Priority Health Medicare |
$59.86
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$95.22
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$59.86
|
Rate for Payer: UHC Dual Complete DSNP |
$59.86
|
Rate for Payer: UHC Medicare Advantage |
$61.66
|
|