|
PR TRANSCATH INTRO, STENT, EXCL COR, CAROT, VERT
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 75960
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$81.90 |
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
|
|
PR TRANSCATH OCCLUSION,PERCUT
|
Professional
|
Both
|
$1,820.00
|
|
|
Service Code
|
HCPCS 37204
|
| Min. Negotiated Rate |
$728.00 |
| Max. Negotiated Rate |
$1,274.00 |
| Rate for Payer: BCBS Complete |
$728.00
|
| Rate for Payer: Cash Price |
$1,456.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,274.00
|
|
|
PR TRANSCATH RX INFUSE OTHER
|
Professional
|
Both
|
$1,607.00
|
|
|
Service Code
|
HCPCS 37202
|
| Min. Negotiated Rate |
$642.80 |
| Max. Negotiated Rate |
$1,124.90 |
| Rate for Payer: BCBS Complete |
$642.80
|
| Rate for Payer: Cash Price |
$1,285.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,124.90
|
|
|
PR TRANSCATH STENT EACH ADDN VESSL,PERC
|
Professional
|
Both
|
$910.00
|
|
|
Service Code
|
HCPCS 37206
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$637.00 |
| Rate for Payer: BCBS Complete |
$364.00
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.00
|
|
|
PR TRANSCATH STENT INIT VESSEL,PERCUT
|
Professional
|
Both
|
$1,685.00
|
|
|
Service Code
|
HCPCS 37205
|
| Min. Negotiated Rate |
$674.00 |
| Max. Negotiated Rate |
$1,179.50 |
| Rate for Payer: BCBS Complete |
$674.00
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,179.50
|
|
|
PR TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART
|
Professional
|
Both
|
$4,430.00
|
|
|
Service Code
|
HCPCS 61596
|
| Min. Negotiated Rate |
$757.05 |
| Max. Negotiated Rate |
$4,141.36 |
| Rate for Payer: Aetna Commercial |
$3,226.92
|
| Rate for Payer: Aetna Medicare |
$2,504.48
|
| Rate for Payer: BCBS Complete |
$1,634.88
|
| Rate for Payer: BCBS MAPPO |
$2,408.15
|
| Rate for Payer: BCBS Trust/PPO |
$757.05
|
| Rate for Payer: BCN Commercial |
$3,574.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,408.15
|
| Rate for Payer: Cash Price |
$3,544.00
|
| Rate for Payer: Cash Price |
$3,544.00
|
| Rate for Payer: Cofinity Commercial |
$3,467.74
|
| Rate for Payer: Cofinity Commercial |
$3,226.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,408.15
|
| Rate for Payer: Mclaren Medicaid |
$1,557.03
|
| Rate for Payer: Meridian Medicaid |
$1,634.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,528.56
|
| Rate for Payer: PACE SWMI |
$2,408.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,408.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,557.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,101.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,141.36
|
| Rate for Payer: Priority Health Medicare |
$2,408.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,141.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,408.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,408.15
|
| Rate for Payer: UHC Medicare Advantage |
$2,480.39
|
|
|
PR TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ
|
Professional
|
Both
|
$662.00
|
|
|
Service Code
|
HCPCS 93893
|
| Min. Negotiated Rate |
$264.80 |
| Max. Negotiated Rate |
$578.11 |
| Rate for Payer: Aetna Commercial |
$494.93
|
| Rate for Payer: Aetna Medicare |
$384.12
|
| Rate for Payer: BCBS Complete |
$264.80
|
| Rate for Payer: BCBS MAPPO |
$369.35
|
| Rate for Payer: BCBS Trust/PPO |
$346.04
|
| Rate for Payer: BCN Commercial |
$578.11
|
| Rate for Payer: BCN Medicare Advantage |
$369.35
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cofinity Commercial |
$494.93
|
| Rate for Payer: Cofinity Commercial |
$531.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$387.82
|
| Rate for Payer: PACE SWMI |
$369.35
|
| Rate for Payer: PHP Medicare Advantage |
$369.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$463.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.34
|
| Rate for Payer: Priority Health Medicare |
$369.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$531.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$369.35
|
| Rate for Payer: UHC Medicare Advantage |
$380.43
|
|
|
PR TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 93892
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$477.58 |
| Rate for Payer: Aetna Commercial |
$400.04
|
| Rate for Payer: Aetna Medicare |
$310.48
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: BCBS MAPPO |
$298.54
|
| Rate for Payer: BCBS Trust/PPO |
$477.58
|
| Rate for Payer: BCN Commercial |
$466.20
|
| Rate for Payer: BCN Medicare Advantage |
$298.54
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$429.90
|
| Rate for Payer: Cofinity Commercial |
$400.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$313.47
|
| Rate for Payer: PACE SWMI |
$298.54
|
| Rate for Payer: PHP Medicare Advantage |
$298.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.48
|
| Rate for Payer: Priority Health Medicare |
$298.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$428.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.54
|
| Rate for Payer: UHC Medicare Advantage |
$307.50
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 93886
|
| Min. Negotiated Rate |
$46.00 |
| Max. Negotiated Rate |
$395.34 |
| Rate for Payer: Aetna Commercial |
$338.94
|
| Rate for Payer: Aetna Commercial |
$338.94
|
| Rate for Payer: Aetna Medicare |
$263.06
|
| Rate for Payer: Aetna Medicare |
$263.06
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS Complete |
$248.00
|
| Rate for Payer: BCBS MAPPO |
$252.94
|
| Rate for Payer: BCBS MAPPO |
$252.94
|
| Rate for Payer: BCBS Trust/PPO |
$362.41
|
| Rate for Payer: BCBS Trust/PPO |
$362.41
|
| Rate for Payer: BCN Commercial |
$395.34
|
| Rate for Payer: BCN Commercial |
$395.34
|
| Rate for Payer: BCN Medicare Advantage |
$252.94
|
| Rate for Payer: BCN Medicare Advantage |
$252.94
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$364.23
|
| Rate for Payer: Cofinity Commercial |
$364.23
|
| Rate for Payer: Cofinity Commercial |
$338.94
|
| Rate for Payer: Cofinity Commercial |
$338.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$265.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$265.59
|
| Rate for Payer: PACE SWMI |
$252.94
|
| Rate for Payer: PACE SWMI |
$252.94
|
| Rate for Payer: PHP Medicare Advantage |
$252.94
|
| Rate for Payer: PHP Medicare Advantage |
$252.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$363.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$363.36
|
| Rate for Payer: Priority Health Medicare |
$252.94
|
| Rate for Payer: Priority Health Medicare |
$252.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$252.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$252.94
|
| Rate for Payer: UHC Medicare Advantage |
$260.53
|
| Rate for Payer: UHC Medicare Advantage |
$260.53
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS 93888
|
| Min. Negotiated Rate |
$118.34 |
| Max. Negotiated Rate |
$252.70 |
| Rate for Payer: Aetna Commercial |
$199.79
|
| Rate for Payer: Aetna Medicare |
$155.06
|
| Rate for Payer: BCBS Complete |
$144.40
|
| Rate for Payer: BCBS MAPPO |
$149.10
|
| Rate for Payer: BCBS Trust/PPO |
$118.34
|
| Rate for Payer: BCN Commercial |
$233.10
|
| Rate for Payer: BCN Medicare Advantage |
$149.10
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$214.70
|
| Rate for Payer: Cofinity Commercial |
$199.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$156.56
|
| Rate for Payer: PACE SWMI |
$149.10
|
| Rate for Payer: PHP Medicare Advantage |
$149.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.24
|
| Rate for Payer: Priority Health Medicare |
$149.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.10
|
| Rate for Payer: UHC Medicare Advantage |
$153.57
|
|
|
PR TRANSECTION/AVULSION GREATER OCCIPITAL NERVE
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 64744
|
| Min. Negotiated Rate |
$331.64 |
| Max. Negotiated Rate |
$870.29 |
| Rate for Payer: Aetna Commercial |
$676.31
|
| Rate for Payer: Aetna Medicare |
$524.90
|
| Rate for Payer: BCBS Complete |
$348.22
|
| Rate for Payer: BCBS MAPPO |
$504.71
|
| Rate for Payer: BCBS Trust/PPO |
$864.83
|
| Rate for Payer: BCN Commercial |
$827.01
|
| Rate for Payer: BCN Medicare Advantage |
$504.71
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cofinity Commercial |
$726.78
|
| Rate for Payer: Cofinity Commercial |
$676.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$504.71
|
| Rate for Payer: Mclaren Medicaid |
$331.64
|
| Rate for Payer: Meridian Medicaid |
$348.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$529.95
|
| Rate for Payer: PACE SWMI |
$504.71
|
| Rate for Payer: PHP Medicare Advantage |
$504.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.29
|
| Rate for Payer: Priority Health Medicare |
$504.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$870.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$504.71
|
| Rate for Payer: UHC Medicare Advantage |
$519.85
|
|
|
PR TRANSECTION/AVULSION OTH SPINAL NRV XDRL
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 64772
|
| Min. Negotiated Rate |
$267.32 |
| Max. Negotiated Rate |
$954.09 |
| Rate for Payer: Aetna Commercial |
$740.27
|
| Rate for Payer: Aetna Medicare |
$574.54
|
| Rate for Payer: BCBS Complete |
$378.64
|
| Rate for Payer: BCBS MAPPO |
$552.44
|
| Rate for Payer: BCBS Trust/PPO |
$267.32
|
| Rate for Payer: BCN Commercial |
$906.65
|
| Rate for Payer: BCN Medicare Advantage |
$552.44
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cofinity Commercial |
$795.51
|
| Rate for Payer: Cofinity Commercial |
$740.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.44
|
| Rate for Payer: Mclaren Medicaid |
$360.61
|
| Rate for Payer: Meridian Medicaid |
$378.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$580.06
|
| Rate for Payer: PACE SWMI |
$552.44
|
| Rate for Payer: PHP Medicare Advantage |
$552.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$896.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$954.09
|
| Rate for Payer: Priority Health Medicare |
$552.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$954.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$552.44
|
| Rate for Payer: UHC Medicare Advantage |
$569.01
|
|
|
PR TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL
|
Professional
|
Both
|
$1,040.00
|
|
|
Service Code
|
HCPCS 64760
|
| Min. Negotiated Rate |
$244.60 |
| Max. Negotiated Rate |
$886.70 |
| Rate for Payer: Aetna Commercial |
$692.87
|
| Rate for Payer: Aetna Medicare |
$537.75
|
| Rate for Payer: BCBS Complete |
$352.70
|
| Rate for Payer: BCBS MAPPO |
$517.07
|
| Rate for Payer: BCBS Trust/PPO |
$244.60
|
| Rate for Payer: BCN Commercial |
$765.27
|
| Rate for Payer: BCN Medicare Advantage |
$517.07
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Cofinity Commercial |
$744.58
|
| Rate for Payer: Cofinity Commercial |
$692.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.07
|
| Rate for Payer: Mclaren Medicaid |
$335.90
|
| Rate for Payer: Meridian Medicaid |
$352.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$542.92
|
| Rate for Payer: PACE SWMI |
$517.07
|
| Rate for Payer: PHP Medicare Advantage |
$517.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$335.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$886.70
|
| Rate for Payer: Priority Health Medicare |
$517.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$886.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.07
|
| Rate for Payer: UHC Medicare Advantage |
$532.58
|
|
|
PR TRANSFER ADDUCTOR ISCHIUM
|
Professional
|
Both
|
$2,605.00
|
|
|
Service Code
|
HCPCS 27098
|
| Min. Negotiated Rate |
$451.13 |
| Max. Negotiated Rate |
$1,823.50 |
| Rate for Payer: Aetna Commercial |
$920.47
|
| Rate for Payer: Aetna Medicare |
$714.40
|
| Rate for Payer: BCBS Complete |
$473.69
|
| Rate for Payer: BCBS MAPPO |
$686.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,106.26
|
| Rate for Payer: BCN Commercial |
$1,026.22
|
| Rate for Payer: BCN Medicare Advantage |
$686.92
|
| Rate for Payer: Cash Price |
$2,084.00
|
| Rate for Payer: Cash Price |
$2,084.00
|
| Rate for Payer: Cofinity Commercial |
$989.16
|
| Rate for Payer: Cofinity Commercial |
$920.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.92
|
| Rate for Payer: Mclaren Medicaid |
$451.13
|
| Rate for Payer: Meridian Medicaid |
$473.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$721.27
|
| Rate for Payer: PACE SWMI |
$686.92
|
| Rate for Payer: PHP Medicare Advantage |
$686.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,823.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.36
|
| Rate for Payer: Priority Health Medicare |
$686.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,072.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$686.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.92
|
| Rate for Payer: UHC Medicare Advantage |
$707.53
|
|
|
PR TRANSFER ANY PEDICLE FLAP ANY LOCATION
|
Professional
|
Both
|
$723.00
|
|
|
Service Code
|
HCPCS 15650
|
| Min. Negotiated Rate |
$75.69 |
| Max. Negotiated Rate |
$794.59 |
| Rate for Payer: Aetna Commercial |
$524.94
|
| Rate for Payer: Aetna Medicare |
$407.42
|
| Rate for Payer: BCBS Complete |
$272.85
|
| Rate for Payer: BCBS MAPPO |
$391.75
|
| Rate for Payer: BCBS Trust/PPO |
$75.69
|
| Rate for Payer: BCN Commercial |
$794.59
|
| Rate for Payer: BCN Medicare Advantage |
$391.75
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$564.12
|
| Rate for Payer: Cofinity Commercial |
$524.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.75
|
| Rate for Payer: Mclaren Medicaid |
$259.86
|
| Rate for Payer: Meridian Medicaid |
$272.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$411.34
|
| Rate for Payer: PACE SWMI |
$391.75
|
| Rate for Payer: PHP Medicare Advantage |
$391.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.13
|
| Rate for Payer: Priority Health Medicare |
$391.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$496.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.75
|
| Rate for Payer: UHC Medicare Advantage |
$403.50
|
|
|
PR TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR
|
Professional
|
Both
|
$6,813.00
|
|
|
Service Code
|
HCPCS 27110
|
| Min. Negotiated Rate |
$626.01 |
| Max. Negotiated Rate |
$4,769.10 |
| Rate for Payer: Aetna Commercial |
$1,283.09
|
| Rate for Payer: Aetna Medicare |
$995.83
|
| Rate for Payer: BCBS Complete |
$657.31
|
| Rate for Payer: BCBS MAPPO |
$957.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.22
|
| Rate for Payer: BCN Commercial |
$1,425.47
|
| Rate for Payer: BCN Medicare Advantage |
$957.53
|
| Rate for Payer: Cash Price |
$5,450.40
|
| Rate for Payer: Cash Price |
$5,450.40
|
| Rate for Payer: Cofinity Commercial |
$1,378.84
|
| Rate for Payer: Cofinity Commercial |
$1,283.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$957.53
|
| Rate for Payer: Mclaren Medicaid |
$626.01
|
| Rate for Payer: Meridian Medicaid |
$657.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,005.41
|
| Rate for Payer: PACE SWMI |
$957.53
|
| Rate for Payer: PHP Medicare Advantage |
$957.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,769.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,489.57
|
| Rate for Payer: Priority Health Medicare |
$957.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,489.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$957.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$957.53
|
| Rate for Payer: UHC Medicare Advantage |
$986.26
|
|
|
PR TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH
|
Professional
|
Both
|
$2,614.00
|
|
|
Service Code
|
HCPCS 26485
|
| Min. Negotiated Rate |
$541.02 |
| Max. Negotiated Rate |
$1,829.80 |
| Rate for Payer: Aetna Commercial |
$1,094.73
|
| Rate for Payer: Aetna Medicare |
$849.64
|
| Rate for Payer: BCBS Complete |
$568.07
|
| Rate for Payer: BCBS MAPPO |
$816.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,205.05
|
| Rate for Payer: BCN Commercial |
$1,242.71
|
| Rate for Payer: BCN Medicare Advantage |
$816.96
|
| Rate for Payer: Cash Price |
$2,091.20
|
| Rate for Payer: Cash Price |
$2,091.20
|
| Rate for Payer: Cofinity Commercial |
$1,176.42
|
| Rate for Payer: Cofinity Commercial |
$1,094.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.96
|
| Rate for Payer: Mclaren Medicaid |
$541.02
|
| Rate for Payer: Meridian Medicaid |
$568.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$857.81
|
| Rate for Payer: PACE SWMI |
$816.96
|
| Rate for Payer: PHP Medicare Advantage |
$816.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,829.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,298.58
|
| Rate for Payer: Priority Health Medicare |
$816.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,298.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$816.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$816.96
|
| Rate for Payer: UHC Medicare Advantage |
$841.47
|
|
|
PR TRANSFUSION BLOOD/BLOOD COMPONENTS
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 36430
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$795.09 |
| Rate for Payer: Aetna Commercial |
$48.55
|
| Rate for Payer: Aetna Medicare |
$37.68
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$36.23
|
| Rate for Payer: BCBS Trust/PPO |
$795.09
|
| Rate for Payer: BCN Commercial |
$57.17
|
| Rate for Payer: BCN Medicare Advantage |
$36.23
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$52.17
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.04
|
| Rate for Payer: PACE SWMI |
$36.23
|
| Rate for Payer: PHP Medicare Advantage |
$36.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.24
|
| Rate for Payer: Priority Health Medicare |
$36.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.23
|
| Rate for Payer: UHC Medicare Advantage |
$37.32
|
|
|
PR TRANSFUSION INTRAUTERINE FETAL
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 36460
|
| Min. Negotiated Rate |
$218.11 |
| Max. Negotiated Rate |
$1,124.75 |
| Rate for Payer: Aetna Commercial |
$458.03
|
| Rate for Payer: Aetna Medicare |
$355.48
|
| Rate for Payer: BCBS Complete |
$229.02
|
| Rate for Payer: BCBS MAPPO |
$341.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.75
|
| Rate for Payer: BCN Commercial |
$499.92
|
| Rate for Payer: BCN Medicare Advantage |
$341.81
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$492.21
|
| Rate for Payer: Cofinity Commercial |
$458.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.81
|
| Rate for Payer: Mclaren Medicaid |
$218.11
|
| Rate for Payer: Meridian Medicaid |
$229.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.90
|
| Rate for Payer: PACE SWMI |
$341.81
|
| Rate for Payer: PHP Medicare Advantage |
$341.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$971.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$544.20
|
| Rate for Payer: Priority Health Medicare |
$341.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$544.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.81
|
| Rate for Payer: UHC Medicare Advantage |
$352.06
|
|
|
PR TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE
|
Professional
|
Both
|
$347.00
|
|
|
Service Code
|
HCPCS 99496
|
| Min. Negotiated Rate |
$120.35 |
| Max. Negotiated Rate |
$294.12 |
| Rate for Payer: Aetna Commercial |
$250.08
|
| Rate for Payer: Aetna Medicare |
$194.10
|
| Rate for Payer: BCBS Complete |
$126.37
|
| Rate for Payer: BCBS MAPPO |
$186.63
|
| Rate for Payer: BCBS Trust/PPO |
$204.98
|
| Rate for Payer: BCN Commercial |
$294.12
|
| Rate for Payer: BCN Medicare Advantage |
$186.63
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cofinity Commercial |
$268.75
|
| Rate for Payer: Cofinity Commercial |
$250.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.63
|
| Rate for Payer: Mclaren Medicaid |
$120.35
|
| Rate for Payer: Meridian Medicaid |
$126.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.96
|
| Rate for Payer: PACE SWMI |
$186.63
|
| Rate for Payer: PHP Medicare Advantage |
$186.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.14
|
| Rate for Payer: Priority Health Medicare |
$186.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.63
|
| Rate for Payer: UHC Medicare Advantage |
$192.23
|
|
|
PR TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 99495
|
| Min. Negotiated Rate |
$88.61 |
| Max. Negotiated Rate |
$935.09 |
| Rate for Payer: Aetna Commercial |
$183.43
|
| Rate for Payer: Aetna Medicare |
$142.37
|
| Rate for Payer: BCBS Complete |
$93.04
|
| Rate for Payer: BCBS MAPPO |
$136.89
|
| Rate for Payer: BCBS Trust/PPO |
$935.09
|
| Rate for Payer: BCN Commercial |
$217.10
|
| Rate for Payer: BCN Medicare Advantage |
$136.89
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$183.43
|
| Rate for Payer: Cofinity Commercial |
$197.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.89
|
| Rate for Payer: Mclaren Medicaid |
$88.61
|
| Rate for Payer: Meridian Medicaid |
$93.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$143.73
|
| Rate for Payer: PACE SWMI |
$136.89
|
| Rate for Payer: PHP Medicare Advantage |
$136.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.89
|
| Rate for Payer: Priority Health Medicare |
$136.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.89
|
| Rate for Payer: UHC Medicare Advantage |
$141.00
|
|
|
PR TRANSLUMINAL BALLOON ANGIOP PERIPHERAL ART RSI
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 75962
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$79.80 |
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
|
|
PR TRANSMASTOID ANTROTOMY
|
Professional
|
Both
|
$1,745.00
|
|
|
Service Code
|
HCPCS 69501
|
| Min. Negotiated Rate |
$457.10 |
| Max. Negotiated Rate |
$3,498.40 |
| Rate for Payer: Aetna Commercial |
$935.61
|
| Rate for Payer: Aetna Medicare |
$726.15
|
| Rate for Payer: BCBS Complete |
$479.96
|
| Rate for Payer: BCBS MAPPO |
$698.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,498.40
|
| Rate for Payer: BCN Commercial |
$1,049.68
|
| Rate for Payer: BCN Medicare Advantage |
$698.22
|
| Rate for Payer: Cash Price |
$1,396.00
|
| Rate for Payer: Cash Price |
$1,396.00
|
| Rate for Payer: Cofinity Commercial |
$935.61
|
| Rate for Payer: Cofinity Commercial |
$1,005.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.22
|
| Rate for Payer: Mclaren Medicaid |
$457.10
|
| Rate for Payer: Meridian Medicaid |
$479.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$733.13
|
| Rate for Payer: PACE SWMI |
$698.22
|
| Rate for Payer: PHP Medicare Advantage |
$698.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,221.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,012.70
|
| Rate for Payer: Priority Health Medicare |
$698.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,012.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.22
|
| Rate for Payer: UHC Medicare Advantage |
$719.17
|
|
|
PR TRANSMETACARPAL AMPUTATION RE-AMPUTATION
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 25931
|
| Min. Negotiated Rate |
$125.23 |
| Max. Negotiated Rate |
$1,554.00 |
| Rate for Payer: Aetna Commercial |
$1,048.13
|
| Rate for Payer: Aetna Medicare |
$813.48
|
| Rate for Payer: BCBS Complete |
$542.36
|
| Rate for Payer: BCBS MAPPO |
$782.19
|
| Rate for Payer: BCBS Trust/PPO |
$125.23
|
| Rate for Payer: BCN Commercial |
$1,185.54
|
| Rate for Payer: BCN Medicare Advantage |
$782.19
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cofinity Commercial |
$1,126.35
|
| Rate for Payer: Cofinity Commercial |
$1,048.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$782.19
|
| Rate for Payer: Mclaren Medicaid |
$516.53
|
| Rate for Payer: Meridian Medicaid |
$542.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$821.30
|
| Rate for Payer: PACE SWMI |
$782.19
|
| Rate for Payer: PHP Medicare Advantage |
$782.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,554.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,238.83
|
| Rate for Payer: Priority Health Medicare |
$782.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,238.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$782.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$782.19
|
| Rate for Payer: UHC Medicare Advantage |
$805.66
|
|
|
PR TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ
|
Professional
|
Both
|
$1,046.00
|
|
|
Service Code
|
HCPCS 25929
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$925.30 |
| Rate for Payer: Aetna Commercial |
$792.94
|
| Rate for Payer: Aetna Medicare |
$615.42
|
| Rate for Payer: BCBS Complete |
$409.50
|
| Rate for Payer: BCBS MAPPO |
$591.75
|
| Rate for Payer: BCBS Trust/PPO |
$2.55
|
| Rate for Payer: BCN Commercial |
$885.48
|
| Rate for Payer: BCN Medicare Advantage |
$591.75
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cofinity Commercial |
$852.12
|
| Rate for Payer: Cofinity Commercial |
$792.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.75
|
| Rate for Payer: Mclaren Medicaid |
$390.00
|
| Rate for Payer: Meridian Medicaid |
$409.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$621.34
|
| Rate for Payer: PACE SWMI |
$591.75
|
| Rate for Payer: PHP Medicare Advantage |
$591.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$925.30
|
| Rate for Payer: Priority Health Medicare |
$591.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$925.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$591.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.75
|
| Rate for Payer: UHC Medicare Advantage |
$609.50
|
|
