|
PR INSERTION PICC W/O IMG GDN 5 YR/>
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 36569
|
| Min. Negotiated Rate |
$54.95 |
| Max. Negotiated Rate |
$378.75 |
| Rate for Payer: Aetna Commercial |
$125.36
|
| Rate for Payer: Aetna Medicare |
$252.50
|
| Rate for Payer: BCBS Complete |
$57.70
|
| Rate for Payer: BCN Commercial |
$139.93
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Mclaren Medicaid |
$54.95
|
| Rate for Payer: Meridian Medicaid |
$57.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.47
|
| Rate for Payer: UHC Medicaid |
$54.95
|
| Rate for Payer: UHCCP Medicaid |
$54.95
|
|
|
PR INSERTION PICC W/RS&I < 5 YR
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 36572
|
| Min. Negotiated Rate |
$46.86 |
| Max. Negotiated Rate |
$651.75 |
| Rate for Payer: Aetna Commercial |
$121.47
|
| Rate for Payer: Aetna Medicare |
$434.50
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCN Commercial |
$119.51
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Mclaren Medicaid |
$46.86
|
| Rate for Payer: Meridian Medicaid |
$49.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$651.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$128.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.52
|
| Rate for Payer: UHC Medicaid |
$46.86
|
| Rate for Payer: UHCCP Medicaid |
$46.86
|
|
|
PR INSERTION PICC W/RS&I 5 YR/>
|
Professional
|
Both
|
$799.00
|
|
|
Service Code
|
HCPCS 36573
|
| Min. Negotiated Rate |
$46.01 |
| Max. Negotiated Rate |
$599.25 |
| Rate for Payer: Aetna Commercial |
$112.87
|
| Rate for Payer: Aetna Medicare |
$399.50
|
| Rate for Payer: BCBS Complete |
$48.31
|
| Rate for Payer: BCN Commercial |
$122.50
|
| Rate for Payer: Cash Price |
$639.20
|
| Rate for Payer: Cash Price |
$639.20
|
| Rate for Payer: Mclaren Medicaid |
$46.01
|
| Rate for Payer: Meridian Medicaid |
$48.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$599.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$131.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.73
|
| Rate for Payer: UHC Medicaid |
$46.01
|
| Rate for Payer: UHCCP Medicaid |
$46.01
|
|
|
PR INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG
|
Professional
|
Both
|
$276.00
|
|
|
Service Code
|
HCPCS 33285
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna Commercial |
$118.22
|
| Rate for Payer: Aetna Medicare |
$138.00
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCN Commercial |
$128.48
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$138.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.16
|
| Rate for Payer: UHC Medicaid |
$48.35
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
|
|
PR INSERTION TANDEM CUFF
|
Professional
|
Both
|
$1,563.00
|
|
|
Service Code
|
HCPCS 53444
|
| Min. Negotiated Rate |
$457.10 |
| Max. Negotiated Rate |
$1,294.32 |
| Rate for Payer: Aetna Commercial |
$1,018.14
|
| Rate for Payer: Aetna Medicare |
$781.50
|
| Rate for Payer: BCBS Complete |
$479.95
|
| Rate for Payer: BCN Commercial |
$1,188.18
|
| Rate for Payer: Cash Price |
$1,250.40
|
| Rate for Payer: Cash Price |
$1,250.40
|
| Rate for Payer: Mclaren Medicaid |
$457.10
|
| Rate for Payer: Meridian Medicaid |
$479.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,172.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,294.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,294.32
|
| Rate for Payer: UHC Medicaid |
$457.10
|
| Rate for Payer: UHCCP Medicaid |
$457.10
|
|
|
PR INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN
|
Professional
|
Both
|
$1,347.00
|
|
|
Service Code
|
HCPCS 49421
|
| Min. Negotiated Rate |
$131.85 |
| Max. Negotiated Rate |
$1,010.25 |
| Rate for Payer: Aetna Commercial |
$308.24
|
| Rate for Payer: Aetna Medicare |
$673.50
|
| Rate for Payer: BCBS Complete |
$138.44
|
| Rate for Payer: BCN Commercial |
$336.64
|
| Rate for Payer: Cash Price |
$1,077.60
|
| Rate for Payer: Cash Price |
$1,077.60
|
| Rate for Payer: Mclaren Medicaid |
$131.85
|
| Rate for Payer: Meridian Medicaid |
$138.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,010.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$410.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.16
|
| Rate for Payer: UHC Medicaid |
$131.85
|
| Rate for Payer: UHCCP Medicaid |
$131.85
|
|
|
PR INSERTION VAGINAL RADIATION DEVICE
|
Professional
|
Both
|
$403.00
|
|
|
Service Code
|
HCPCS 57156
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$302.25 |
| Rate for Payer: Aetna Commercial |
$176.91
|
| Rate for Payer: Aetna Medicare |
$201.50
|
| Rate for Payer: BCBS Complete |
$84.99
|
| Rate for Payer: BCN Commercial |
$228.57
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Mclaren Medicaid |
$80.94
|
| Rate for Payer: Meridian Medicaid |
$84.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$302.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$231.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.49
|
| Rate for Payer: UHC Medicaid |
$80.94
|
| Rate for Payer: UHCCP Medicaid |
$80.94
|
|
|
PR INSERTION VASCULAR PEDICLE CARPAL BONE
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 25430
|
| Min. Negotiated Rate |
$443.47 |
| Max. Negotiated Rate |
$1,199.34 |
| Rate for Payer: Aetna Commercial |
$974.68
|
| Rate for Payer: Aetna Medicare |
$636.00
|
| Rate for Payer: BCBS Complete |
$465.64
|
| Rate for Payer: BCN Commercial |
$1,121.95
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Mclaren Medicaid |
$443.47
|
| Rate for Payer: Meridian Medicaid |
$465.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$954.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,199.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,199.34
|
| Rate for Payer: UHC Medicaid |
$443.47
|
| Rate for Payer: UHCCP Medicaid |
$443.47
|
|
|
PR INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 20650
|
| Min. Negotiated Rate |
$102.03 |
| Max. Negotiated Rate |
$273.61 |
| Rate for Payer: Aetna Commercial |
$209.70
|
| Rate for Payer: Aetna Medicare |
$170.00
|
| Rate for Payer: BCBS Complete |
$107.13
|
| Rate for Payer: BCN Commercial |
$255.97
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Mclaren Medicaid |
$102.03
|
| Rate for Payer: Meridian Medicaid |
$107.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$273.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.61
|
| Rate for Payer: UHC Medicaid |
$102.03
|
| Rate for Payer: UHCCP Medicaid |
$102.03
|
|
|
PR INSERT POST SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR, EA ADD
|
Professional
|
Both
|
$545.00
|
|
|
Service Code
|
HCPCS 0172T
|
| Min. Negotiated Rate |
$218.00 |
| Max. Negotiated Rate |
$408.75 |
| Rate for Payer: Aetna Medicare |
$272.50
|
| Rate for Payer: BCBS Complete |
$218.00
|
| Rate for Payer: Cash Price |
$436.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$408.75
|
|
|
PR INSERT POST SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR, SINGLE
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 0171T
|
| Min. Negotiated Rate |
$1,126.40 |
| Max. Negotiated Rate |
$2,112.00 |
| Rate for Payer: Aetna Medicare |
$1,408.00
|
| Rate for Payer: BCBS Complete |
$1,126.40
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,112.00
|
|
|
PR INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT
|
Professional
|
Both
|
$1,203.00
|
|
|
Service Code
|
HCPCS 53855
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$902.25 |
| Rate for Payer: Aetna Commercial |
$105.97
|
| Rate for Payer: Aetna Medicare |
$601.50
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCN Commercial |
$121.01
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Mclaren Medicaid |
$45.80
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$902.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$131.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.82
|
| Rate for Payer: UHC Medicaid |
$45.80
|
| Rate for Payer: UHCCP Medicaid |
$45.80
|
|
|
PR INSERT TRAY W/O BAG/CATH
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS A4310
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$10.54 |
| Rate for Payer: Aetna Commercial |
$7.19
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCN Commercial |
$10.54
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
|
|
PR INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR
|
Professional
|
Both
|
$2,211.00
|
|
|
Service Code
|
HCPCS 36557
|
| Min. Negotiated Rate |
$196.60 |
| Max. Negotiated Rate |
$1,658.25 |
| Rate for Payer: Aetna Commercial |
$429.02
|
| Rate for Payer: Aetna Medicare |
$1,105.50
|
| Rate for Payer: BCBS Complete |
$206.43
|
| Rate for Payer: BCN Commercial |
$482.05
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Mclaren Medicaid |
$196.60
|
| Rate for Payer: Meridian Medicaid |
$206.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$518.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$518.37
|
| Rate for Payer: UHC Medicaid |
$196.60
|
| Rate for Payer: UHCCP Medicaid |
$196.60
|
|
|
PR INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I
|
Professional
|
Both
|
$2,857.00
|
|
|
Service Code
|
HCPCS 37191
|
| Min. Negotiated Rate |
$121.84 |
| Max. Negotiated Rate |
$2,142.75 |
| Rate for Payer: Aetna Commercial |
$297.44
|
| Rate for Payer: Aetna Medicare |
$1,428.50
|
| Rate for Payer: BCBS Complete |
$127.93
|
| Rate for Payer: BCN Commercial |
$321.70
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Mclaren Medicaid |
$121.84
|
| Rate for Payer: Meridian Medicaid |
$127.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,142.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$345.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$345.95
|
| Rate for Payer: UHC Medicaid |
$121.84
|
| Rate for Payer: UHCCP Medicaid |
$121.84
|
|
|
PR IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART
|
Professional
|
Both
|
$3,408.00
|
|
|
Service Code
|
HCPCS 35585
|
| Min. Negotiated Rate |
$961.70 |
| Max. Negotiated Rate |
$2,618.13 |
| Rate for Payer: Aetna Commercial |
$2,251.28
|
| Rate for Payer: Aetna Medicare |
$1,704.00
|
| Rate for Payer: BCBS Complete |
$1,009.78
|
| Rate for Payer: BCN Commercial |
$2,434.63
|
| Rate for Payer: Cash Price |
$2,726.40
|
| Rate for Payer: Cash Price |
$2,726.40
|
| Rate for Payer: Mclaren Medicaid |
$961.70
|
| Rate for Payer: Meridian Medicaid |
$1,009.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,556.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$961.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,618.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,618.13
|
| Rate for Payer: UHC Medicaid |
$961.70
|
| Rate for Payer: UHCCP Medicaid |
$961.70
|
|
|
PR IN-SITU VEIN BYPASS FEMORAL-POPLITEAL
|
Professional
|
Both
|
$4,804.00
|
|
|
Service Code
|
HCPCS 35583
|
| Min. Negotiated Rate |
$830.27 |
| Max. Negotiated Rate |
$3,603.00 |
| Rate for Payer: Aetna Commercial |
$1,939.24
|
| Rate for Payer: Aetna Medicare |
$2,402.00
|
| Rate for Payer: BCBS Complete |
$871.78
|
| Rate for Payer: BCN Commercial |
$2,102.97
|
| Rate for Payer: Cash Price |
$3,843.20
|
| Rate for Payer: Cash Price |
$3,843.20
|
| Rate for Payer: Mclaren Medicaid |
$830.27
|
| Rate for Payer: Meridian Medicaid |
$871.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,603.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$830.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,261.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,261.48
|
| Rate for Payer: UHC Medicaid |
$830.27
|
| Rate for Payer: UHCCP Medicaid |
$830.27
|
|
|
PR IN-SITU VEIN BYP POP-TIBL PRONEAL
|
Professional
|
Both
|
$2,937.00
|
|
|
Service Code
|
HCPCS 35587
|
| Min. Negotiated Rate |
$773.19 |
| Max. Negotiated Rate |
$2,202.75 |
| Rate for Payer: Aetna Commercial |
$1,824.84
|
| Rate for Payer: Aetna Medicare |
$1,468.50
|
| Rate for Payer: BCBS Complete |
$811.85
|
| Rate for Payer: BCN Commercial |
$1,949.10
|
| Rate for Payer: Cash Price |
$2,349.60
|
| Rate for Payer: Cash Price |
$2,349.60
|
| Rate for Payer: Mclaren Medicaid |
$773.19
|
| Rate for Payer: Meridian Medicaid |
$811.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,202.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$773.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,096.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,096.00
|
| Rate for Payer: UHC Medicaid |
$773.19
|
| Rate for Payer: UHCCP Medicaid |
$773.19
|
|
|
PR INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,278.00
|
|
|
Service Code
|
HCPCS 33216
|
| Min. Negotiated Rate |
$211.30 |
| Max. Negotiated Rate |
$958.50 |
| Rate for Payer: Aetna Commercial |
$497.89
|
| Rate for Payer: Aetna Medicare |
$639.00
|
| Rate for Payer: BCBS Complete |
$221.87
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: Cash Price |
$1,022.40
|
| Rate for Payer: Cash Price |
$1,022.40
|
| Rate for Payer: Mclaren Medicaid |
$211.30
|
| Rate for Payer: Meridian Medicaid |
$221.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$958.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$590.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$590.14
|
| Rate for Payer: UHC Medicaid |
$211.30
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
|
|
PR INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,278.00
|
|
|
Service Code
|
HCPCS 33217
|
| Min. Negotiated Rate |
$210.66 |
| Max. Negotiated Rate |
$958.50 |
| Rate for Payer: Aetna Commercial |
$493.05
|
| Rate for Payer: Aetna Medicare |
$639.00
|
| Rate for Payer: BCBS Complete |
$221.19
|
| Rate for Payer: BCN Commercial |
$545.79
|
| Rate for Payer: Cash Price |
$1,022.40
|
| Rate for Payer: Cash Price |
$1,022.40
|
| Rate for Payer: Mclaren Medicaid |
$210.66
|
| Rate for Payer: Meridian Medicaid |
$221.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$958.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$586.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$586.93
|
| Rate for Payer: UHC Medicaid |
$210.66
|
| Rate for Payer: UHCCP Medicaid |
$210.66
|
|
|
PR INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 22853
|
| Min. Negotiated Rate |
$145.91 |
| Max. Negotiated Rate |
$421.50 |
| Rate for Payer: Aetna Commercial |
$347.96
|
| Rate for Payer: Aetna Medicare |
$281.00
|
| Rate for Payer: BCBS Complete |
$153.21
|
| Rate for Payer: BCN Commercial |
$385.44
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Mclaren Medicaid |
$145.91
|
| Rate for Payer: Meridian Medicaid |
$153.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$412.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$412.02
|
| Rate for Payer: UHC Medicaid |
$145.91
|
| Rate for Payer: UHCCP Medicaid |
$145.91
|
|
|
PR INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD
|
Professional
|
Both
|
$2,356.00
|
|
|
Service Code
|
HCPCS 22859
|
| Min. Negotiated Rate |
$191.49 |
| Max. Negotiated Rate |
$1,767.00 |
| Rate for Payer: Aetna Commercial |
$449.13
|
| Rate for Payer: Aetna Medicare |
$1,178.00
|
| Rate for Payer: BCBS Complete |
$201.06
|
| Rate for Payer: BCN Commercial |
$501.47
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Mclaren Medicaid |
$191.49
|
| Rate for Payer: Meridian Medicaid |
$201.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,767.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$536.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$536.06
|
| Rate for Payer: UHC Medicaid |
$191.49
|
| Rate for Payer: UHCCP Medicaid |
$191.49
|
|
|
PR INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD
|
Professional
|
Both
|
$909.00
|
|
|
Service Code
|
HCPCS 22854
|
| Min. Negotiated Rate |
$191.70 |
| Max. Negotiated Rate |
$681.75 |
| Rate for Payer: Aetna Commercial |
$450.55
|
| Rate for Payer: Aetna Medicare |
$454.50
|
| Rate for Payer: BCBS Complete |
$201.28
|
| Rate for Payer: BCN Commercial |
$501.96
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Mclaren Medicaid |
$191.70
|
| Rate for Payer: Meridian Medicaid |
$201.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$681.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$536.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$536.58
|
| Rate for Payer: UHC Medicaid |
$191.70
|
| Rate for Payer: UHCCP Medicaid |
$191.70
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL
|
Professional
|
Both
|
$1,527.00
|
|
|
Service Code
|
HCPCS 36810
|
| Min. Negotiated Rate |
$113.10 |
| Max. Negotiated Rate |
$1,145.25 |
| Rate for Payer: Aetna Commercial |
$285.92
|
| Rate for Payer: Aetna Medicare |
$763.50
|
| Rate for Payer: BCBS Complete |
$118.75
|
| Rate for Payer: BCN Commercial |
$284.34
|
| Rate for Payer: Cash Price |
$1,221.60
|
| Rate for Payer: Cash Price |
$1,221.60
|
| Rate for Payer: Mclaren Medicaid |
$113.10
|
| Rate for Payer: Meridian Medicaid |
$118.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,145.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$305.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.78
|
| Rate for Payer: UHC Medicaid |
$113.10
|
| Rate for Payer: UHCCP Medicaid |
$113.10
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN
|
Professional
|
Both
|
$685.00
|
|
|
Service Code
|
HCPCS 36800
|
| Min. Negotiated Rate |
$68.59 |
| Max. Negotiated Rate |
$513.75 |
| Rate for Payer: Aetna Commercial |
$164.38
|
| Rate for Payer: Aetna Medicare |
$342.50
|
| Rate for Payer: BCBS Complete |
$72.02
|
| Rate for Payer: BCN Commercial |
$177.29
|
| Rate for Payer: Cash Price |
$548.00
|
| Rate for Payer: Cash Price |
$548.00
|
| Rate for Payer: Mclaren Medicaid |
$68.59
|
| Rate for Payer: Meridian Medicaid |
$72.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$190.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.64
|
| Rate for Payer: UHC Medicaid |
$68.59
|
| Rate for Payer: UHCCP Medicaid |
$68.59
|
|
