|
PR INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 93662
|
| Min. Negotiated Rate |
$102.60 |
| Max. Negotiated Rate |
$226.50 |
| Rate for Payer: Aetna Commercial |
$195.64
|
| Rate for Payer: Aetna Commercial |
$195.64
|
| Rate for Payer: Aetna Medicare |
$151.00
|
| Rate for Payer: Aetna Medicare |
$288.00
|
| Rate for Payer: BCN Commercial |
$102.60
|
| Rate for Payer: BCN Commercial |
$102.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$432.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$130.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$130.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.15
|
|
|
PR INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING
|
Professional
|
Both
|
$1,237.00
|
|
|
Service Code
|
HCPCS 93613
|
| Min. Negotiated Rate |
$158.05 |
| Max. Negotiated Rate |
$927.75 |
| Rate for Payer: Aetna Commercial |
$397.73
|
| Rate for Payer: Aetna Medicare |
$618.50
|
| Rate for Payer: BCBS Complete |
$165.95
|
| Rate for Payer: BCN Commercial |
$423.78
|
| Rate for Payer: Cash Price |
$989.60
|
| Rate for Payer: Cash Price |
$989.60
|
| Rate for Payer: Mclaren Medicaid |
$158.05
|
| Rate for Payer: Meridian Medicaid |
$165.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$927.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$402.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.79
|
| Rate for Payer: UHC Medicaid |
$158.05
|
| Rate for Payer: UHCCP Medicaid |
$158.05
|
|
|
PR INTRA COPP CONTRA (PARAGARD)
|
Professional
|
Both
|
$1,394.00
|
|
|
Service Code
|
HCPCS J7300
|
| Min. Negotiated Rate |
$697.00 |
| Max. Negotiated Rate |
$1,267.71 |
| Rate for Payer: Aetna Commercial |
$1,085.00
|
| Rate for Payer: Aetna Medicare |
$697.00
|
| Rate for Payer: BCBS Complete |
$1,267.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,196.15
|
| Rate for Payer: BCN Commercial |
$1,150.85
|
| Rate for Payer: Cash Price |
$1,115.20
|
| Rate for Payer: Cash Price |
$1,115.20
|
| Rate for Payer: Mclaren Medicaid |
$1,207.34
|
| Rate for Payer: Meridian Medicaid |
$1,267.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,045.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,207.34
|
| Rate for Payer: UHC Medicaid |
$1,207.34
|
| Rate for Payer: UHCCP Medicaid |
$1,207.34
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ DURAL CMPL
|
Professional
|
Both
|
$9,488.00
|
|
|
Service Code
|
HCPCS 61692
|
| Min. Negotiated Rate |
$2,210.73 |
| Max. Negotiated Rate |
$7,116.00 |
| Rate for Payer: Aetna Commercial |
$4,717.73
|
| Rate for Payer: Aetna Medicare |
$4,744.00
|
| Rate for Payer: BCBS Complete |
$2,321.27
|
| Rate for Payer: BCN Commercial |
$5,524.10
|
| Rate for Payer: Cash Price |
$7,590.40
|
| Rate for Payer: Cash Price |
$7,590.40
|
| Rate for Payer: Mclaren Medicaid |
$2,210.73
|
| Rate for Payer: Meridian Medicaid |
$2,321.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,116.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,210.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,416.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,416.15
|
| Rate for Payer: UHC Medicaid |
$2,210.73
|
| Rate for Payer: UHCCP Medicaid |
$2,210.73
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ DURAL SMPL
|
Professional
|
Both
|
$8,055.00
|
|
|
Service Code
|
HCPCS 61690
|
| Min. Negotiated Rate |
$1,354.25 |
| Max. Negotiated Rate |
$6,041.25 |
| Rate for Payer: Aetna Commercial |
$2,817.87
|
| Rate for Payer: Aetna Medicare |
$4,027.50
|
| Rate for Payer: BCBS Complete |
$1,421.96
|
| Rate for Payer: BCN Commercial |
$3,323.52
|
| Rate for Payer: Cash Price |
$6,444.00
|
| Rate for Payer: Cash Price |
$6,444.00
|
| Rate for Payer: Mclaren Medicaid |
$1,354.25
|
| Rate for Payer: Meridian Medicaid |
$1,421.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,041.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,354.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,860.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,860.22
|
| Rate for Payer: UHC Medicaid |
$1,354.25
|
| Rate for Payer: UHCCP Medicaid |
$1,354.25
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL
|
Professional
|
Both
|
$12,487.00
|
|
|
Service Code
|
HCPCS 61686
|
| Min. Negotiated Rate |
$2,709.36 |
| Max. Negotiated Rate |
$9,383.95 |
| Rate for Payer: Aetna Commercial |
$5,806.18
|
| Rate for Payer: Aetna Medicare |
$6,243.50
|
| Rate for Payer: BCBS Complete |
$2,844.83
|
| Rate for Payer: BCN Commercial |
$9,383.95
|
| Rate for Payer: Cash Price |
$9,989.60
|
| Rate for Payer: Cash Price |
$9,989.60
|
| Rate for Payer: Mclaren Medicaid |
$2,709.36
|
| Rate for Payer: Meridian Medicaid |
$2,844.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,365.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,709.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,889.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,889.31
|
| Rate for Payer: UHC Medicaid |
$2,709.36
|
| Rate for Payer: UHCCP Medicaid |
$2,709.36
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL
|
Professional
|
Both
|
$6,167.00
|
|
|
Service Code
|
HCPCS 61684
|
| Min. Negotiated Rate |
$1,741.70 |
| Max. Negotiated Rate |
$5,962.66 |
| Rate for Payer: Aetna Commercial |
$3,673.33
|
| Rate for Payer: Aetna Medicare |
$3,083.50
|
| Rate for Payer: BCBS Complete |
$1,828.79
|
| Rate for Payer: BCN Commercial |
$5,962.66
|
| Rate for Payer: Cash Price |
$4,933.60
|
| Rate for Payer: Cash Price |
$4,933.60
|
| Rate for Payer: Mclaren Medicaid |
$1,741.70
|
| Rate for Payer: Meridian Medicaid |
$1,828.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,625.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,741.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,012.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,012.95
|
| Rate for Payer: UHC Medicaid |
$1,741.70
|
| Rate for Payer: UHCCP Medicaid |
$1,741.70
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL
|
Professional
|
Both
|
$9,183.00
|
|
|
Service Code
|
HCPCS 61682
|
| Min. Negotiated Rate |
$2,476.13 |
| Max. Negotiated Rate |
$8,649.20 |
| Rate for Payer: Aetna Commercial |
$5,378.16
|
| Rate for Payer: Aetna Medicare |
$4,591.50
|
| Rate for Payer: BCBS Complete |
$2,599.94
|
| Rate for Payer: BCN Commercial |
$8,649.20
|
| Rate for Payer: Cash Price |
$7,346.40
|
| Rate for Payer: Cash Price |
$7,346.40
|
| Rate for Payer: Mclaren Medicaid |
$2,476.13
|
| Rate for Payer: Meridian Medicaid |
$2,599.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,887.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,476.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,271.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,271.59
|
| Rate for Payer: UHC Medicaid |
$2,476.13
|
| Rate for Payer: UHCCP Medicaid |
$2,476.13
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL
|
Professional
|
Both
|
$4,897.00
|
|
|
Service Code
|
HCPCS 61680
|
| Min. Negotiated Rate |
$1,407.72 |
| Max. Negotiated Rate |
$4,742.20 |
| Rate for Payer: Aetna Commercial |
$2,931.17
|
| Rate for Payer: Aetna Medicare |
$2,448.50
|
| Rate for Payer: BCBS Complete |
$1,478.11
|
| Rate for Payer: BCN Commercial |
$4,742.20
|
| Rate for Payer: Cash Price |
$3,917.60
|
| Rate for Payer: Cash Price |
$3,917.60
|
| Rate for Payer: Mclaren Medicaid |
$1,407.72
|
| Rate for Payer: Meridian Medicaid |
$1,478.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,672.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,407.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,986.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,986.87
|
| Rate for Payer: UHC Medicaid |
$1,407.72
|
| Rate for Payer: UHCCP Medicaid |
$1,407.72
|
|
|
PR INTRAFRACTION TRACK MOTION
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS G6017
|
| Min. Negotiated Rate |
$72.40 |
| Max. Negotiated Rate |
$135.75 |
| Rate for Payer: Aetna Commercial |
$94.22
|
| Rate for Payer: Aetna Medicare |
$90.50
|
| Rate for Payer: BCBS Complete |
$72.40
|
| Rate for Payer: BCN Commercial |
$105.75
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.75
|
|
|
PR INTRAOPERATIVE COLONIC LAVAGE
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 44701
|
| Min. Negotiated Rate |
$97.13 |
| Max. Negotiated Rate |
$318.00 |
| Rate for Payer: Aetna Commercial |
$229.50
|
| Rate for Payer: Aetna Medicare |
$212.00
|
| Rate for Payer: BCBS Complete |
$101.99
|
| Rate for Payer: BCN Commercial |
$252.48
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Mclaren Medicaid |
$97.13
|
| Rate for Payer: Meridian Medicaid |
$101.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$307.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.63
|
| Rate for Payer: UHC Medicaid |
$97.13
|
| Rate for Payer: UHCCP Medicaid |
$97.13
|
|
|
PR INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 38900
|
| Min. Negotiated Rate |
$78.38 |
| Max. Negotiated Rate |
$272.32 |
| Rate for Payer: Aetna Commercial |
$172.38
|
| Rate for Payer: Aetna Medicare |
$157.00
|
| Rate for Payer: BCBS Complete |
$82.30
|
| Rate for Payer: BCN Commercial |
$204.67
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Mclaren Medicaid |
$78.38
|
| Rate for Payer: Meridian Medicaid |
$82.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$272.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$272.32
|
| Rate for Payer: UHC Medicaid |
$78.38
|
| Rate for Payer: UHCCP Medicaid |
$78.38
|
|
|
PR INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE
|
Professional
|
Both
|
$703.00
|
|
|
Service Code
|
HCPCS 41009
|
| Min. Negotiated Rate |
$168.48 |
| Max. Negotiated Rate |
$529.69 |
| Rate for Payer: Aetna Commercial |
$371.20
|
| Rate for Payer: Aetna Medicare |
$351.50
|
| Rate for Payer: BCBS Complete |
$176.90
|
| Rate for Payer: BCN Commercial |
$434.74
|
| Rate for Payer: Cash Price |
$562.40
|
| Rate for Payer: Cash Price |
$562.40
|
| Rate for Payer: Mclaren Medicaid |
$168.48
|
| Rate for Payer: Meridian Medicaid |
$176.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$527.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$529.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.69
|
| Rate for Payer: UHC Medicaid |
$168.48
|
| Rate for Payer: UHCCP Medicaid |
$168.48
|
|
|
PR INTRAORAL I&D TONGUE/FLOOR SUBLNGL DP SPRMLHYD
|
Professional
|
Both
|
$619.00
|
|
|
Service Code
|
HCPCS 41006
|
| Min. Negotiated Rate |
$137.39 |
| Max. Negotiated Rate |
$464.25 |
| Rate for Payer: Aetna Commercial |
$301.56
|
| Rate for Payer: Aetna Medicare |
$309.50
|
| Rate for Payer: BCBS Complete |
$144.26
|
| Rate for Payer: BCN Commercial |
$354.07
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Mclaren Medicaid |
$137.39
|
| Rate for Payer: Meridian Medicaid |
$144.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$464.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$431.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$431.40
|
| Rate for Payer: UHC Medicaid |
$137.39
|
| Rate for Payer: UHCCP Medicaid |
$137.39
|
|
|
PR INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 41005
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$303.00 |
| Rate for Payer: Aetna Commercial |
$144.95
|
| Rate for Payer: Aetna Medicare |
$202.00
|
| Rate for Payer: BCBS Complete |
$74.93
|
| Rate for Payer: BCN Commercial |
$178.28
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Mclaren Medicaid |
$71.36
|
| Rate for Payer: Meridian Medicaid |
$74.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$217.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.22
|
| Rate for Payer: UHC Medicaid |
$71.36
|
| Rate for Payer: UHCCP Medicaid |
$71.36
|
|
|
PR INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 41008
|
| Min. Negotiated Rate |
$156.13 |
| Max. Negotiated Rate |
$546.00 |
| Rate for Payer: Aetna Commercial |
$338.86
|
| Rate for Payer: Aetna Medicare |
$364.00
|
| Rate for Payer: BCBS Complete |
$163.94
|
| Rate for Payer: BCN Commercial |
$397.89
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Mclaren Medicaid |
$156.13
|
| Rate for Payer: Meridian Medicaid |
$163.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$484.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$484.80
|
| Rate for Payer: UHC Medicaid |
$156.13
|
| Rate for Payer: UHCCP Medicaid |
$156.13
|
|
|
PR INTRAPULMONARY SURFACTANT ADMN PHYS/QHP
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 94610
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$86.25 |
| Rate for Payer: Aetna Commercial |
$61.24
|
| Rate for Payer: Aetna Medicare |
$57.50
|
| Rate for Payer: BCBS Complete |
$31.98
|
| Rate for Payer: BCN Commercial |
$82.17
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Mclaren Medicaid |
$30.46
|
| Rate for Payer: Meridian Medicaid |
$31.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.77
|
| Rate for Payer: UHC Medicaid |
$30.46
|
| Rate for Payer: UHCCP Medicaid |
$30.46
|
|
|
PR INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL
|
Professional
|
Both
|
$437.00
|
|
|
Service Code
|
HCPCS 37253
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$327.75 |
| Rate for Payer: Aetna Commercial |
$95.73
|
| Rate for Payer: Aetna Medicare |
$218.50
|
| Rate for Payer: BCBS Complete |
$41.82
|
| Rate for Payer: BCN Commercial |
$103.58
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Mclaren Medicaid |
$39.83
|
| Rate for Payer: Meridian Medicaid |
$41.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$111.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.39
|
| Rate for Payer: UHC Medicaid |
$39.83
|
| Rate for Payer: UHCCP Medicaid |
$39.83
|
|
|
PR INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL
|
Professional
|
Both
|
$199.00
|
|
|
Service Code
|
HCPCS 37252
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$149.25 |
| Rate for Payer: Aetna Commercial |
$120.70
|
| Rate for Payer: Aetna Medicare |
$99.50
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCN Commercial |
$129.97
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Mclaren Medicaid |
$50.48
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.76
|
| Rate for Payer: UHC Medicaid |
$50.48
|
| Rate for Payer: UHCCP Medicaid |
$50.48
|
|
|
PR INTRAVASC US DURING DX EVAL/ INTERVENTION,EA ADDN VESSEL
|
Professional
|
Both
|
$420.00
|
|
|
Service Code
|
HCPCS 37251
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Medicare |
$210.00
|
| Rate for Payer: BCBS Complete |
$168.00
|
| Rate for Payer: Cash Price |
$336.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.00
|
|
|
PR INTRA-VNTR MAPG TACHYCARDIA SITES W/CATH MNPJ
|
Professional
|
Both
|
$602.00
|
|
|
Service Code
|
HCPCS 93609
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$522.05 |
| Rate for Payer: Aetna Commercial |
$507.22
|
| Rate for Payer: Aetna Medicare |
$301.00
|
| Rate for Payer: BCN Commercial |
$395.40
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$451.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$522.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$522.05
|
|
|
PR INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 57180
|
| Min. Negotiated Rate |
$68.16 |
| Max. Negotiated Rate |
$184.08 |
| Rate for Payer: Aetna Commercial |
$141.44
|
| Rate for Payer: Aetna Medicare |
$114.00
|
| Rate for Payer: BCBS Complete |
$71.57
|
| Rate for Payer: BCN Commercial |
$181.76
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Mclaren Medicaid |
$68.16
|
| Rate for Payer: Meridian Medicaid |
$71.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$184.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.08
|
| Rate for Payer: UHC Medicaid |
$68.16
|
| Rate for Payer: UHCCP Medicaid |
$68.16
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I
|
Professional
|
Both
|
$389.00
|
|
|
Service Code
|
HCPCS 36901
|
| Min. Negotiated Rate |
$93.93 |
| Max. Negotiated Rate |
$291.75 |
| Rate for Payer: Aetna Commercial |
$225.47
|
| Rate for Payer: Aetna Medicare |
$194.50
|
| Rate for Payer: BCBS Complete |
$98.63
|
| Rate for Payer: BCN Commercial |
$246.00
|
| Rate for Payer: Cash Price |
$311.20
|
| Rate for Payer: Cash Price |
$311.20
|
| Rate for Payer: Mclaren Medicaid |
$93.93
|
| Rate for Payer: Meridian Medicaid |
$98.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$264.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.54
|
| Rate for Payer: UHC Medicaid |
$93.93
|
| Rate for Payer: UHCCP Medicaid |
$93.93
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT
|
Professional
|
Both
|
$794.00
|
|
|
Service Code
|
HCPCS 36903
|
| Min. Negotiated Rate |
$177.00 |
| Max. Negotiated Rate |
$595.50 |
| Rate for Payer: Aetna Commercial |
$423.38
|
| Rate for Payer: Aetna Medicare |
$397.00
|
| Rate for Payer: BCBS Complete |
$185.85
|
| Rate for Payer: BCN Commercial |
$459.14
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Mclaren Medicaid |
$177.00
|
| Rate for Payer: Meridian Medicaid |
$185.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$595.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$493.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.74
|
| Rate for Payer: UHC Medicaid |
$177.00
|
| Rate for Payer: UHCCP Medicaid |
$177.00
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 36902
|
| Min. Negotiated Rate |
$133.98 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Aetna Commercial |
$321.04
|
| Rate for Payer: Aetna Medicare |
$290.00
|
| Rate for Payer: BCBS Complete |
$140.68
|
| Rate for Payer: BCN Commercial |
$349.08
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Mclaren Medicaid |
$133.98
|
| Rate for Payer: Meridian Medicaid |
$140.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$375.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$375.40
|
| Rate for Payer: UHC Medicaid |
$133.98
|
| Rate for Payer: UHCCP Medicaid |
$133.98
|
|
