|
PR TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 33141
|
| Min. Negotiated Rate |
$82.22 |
| Max. Negotiated Rate |
$1,088.30 |
| Rate for Payer: Aetna Commercial |
$174.03
|
| Rate for Payer: Aetna Medicare |
$135.06
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS MAPPO |
$129.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,088.30
|
| Rate for Payer: BCN Commercial |
$188.15
|
| Rate for Payer: BCN Medicare Advantage |
$129.87
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cofinity Commercial |
$187.01
|
| Rate for Payer: Cofinity Commercial |
$174.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.87
|
| Rate for Payer: Mclaren Medicaid |
$82.22
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$136.36
|
| Rate for Payer: PACE SWMI |
$129.87
|
| Rate for Payer: PHP Medicare Advantage |
$129.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.81
|
| Rate for Payer: Priority Health Medicare |
$129.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.87
|
| Rate for Payer: UHC Medicare Advantage |
$133.77
|
|
|
PR TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR
|
Professional
|
Both
|
$2,425.00
|
|
|
Service Code
|
HCPCS 63057
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$1,697.50 |
| Rate for Payer: Aetna Commercial |
$430.56
|
| Rate for Payer: Aetna Medicare |
$334.16
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCBS MAPPO |
$321.31
|
| Rate for Payer: BCBS Trust/PPO |
$543.09
|
| Rate for Payer: BCN Commercial |
$515.47
|
| Rate for Payer: BCN Medicare Advantage |
$321.31
|
| Rate for Payer: Cash Price |
$1,940.00
|
| Rate for Payer: Cash Price |
$1,940.00
|
| Rate for Payer: Cofinity Commercial |
$462.69
|
| Rate for Payer: Cofinity Commercial |
$430.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.31
|
| Rate for Payer: Mclaren Medicaid |
$204.91
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$337.38
|
| Rate for Payer: PACE SWMI |
$321.31
|
| Rate for Payer: PHP Medicare Advantage |
$321.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,697.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.44
|
| Rate for Payer: Priority Health Medicare |
$321.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$542.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$321.31
|
| Rate for Payer: UHC Medicare Advantage |
$330.95
|
|
|
PR TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR
|
Professional
|
Both
|
$6,935.00
|
|
|
Service Code
|
HCPCS 63056
|
| Min. Negotiated Rate |
$545.21 |
| Max. Negotiated Rate |
$4,854.50 |
| Rate for Payer: Aetna Commercial |
$1,998.94
|
| Rate for Payer: Aetna Medicare |
$1,551.42
|
| Rate for Payer: BCBS Complete |
$1,010.45
|
| Rate for Payer: BCBS MAPPO |
$1,491.75
|
| Rate for Payer: BCBS Trust/PPO |
$545.21
|
| Rate for Payer: BCN Commercial |
$2,415.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,491.75
|
| Rate for Payer: Cash Price |
$5,548.00
|
| Rate for Payer: Cash Price |
$5,548.00
|
| Rate for Payer: Cofinity Commercial |
$1,998.94
|
| Rate for Payer: Cofinity Commercial |
$2,148.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,491.75
|
| Rate for Payer: Mclaren Medicaid |
$962.33
|
| Rate for Payer: Meridian Medicaid |
$1,010.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,566.34
|
| Rate for Payer: PACE SWMI |
$1,491.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,491.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$962.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,854.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,542.35
|
| Rate for Payer: Priority Health Medicare |
$1,491.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,542.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,491.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,491.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,536.50
|
|
|
PR TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC
|
Professional
|
Both
|
$7,309.00
|
|
|
Service Code
|
HCPCS 63055
|
| Min. Negotiated Rate |
$470.19 |
| Max. Negotiated Rate |
$5,116.30 |
| Rate for Payer: Aetna Commercial |
$2,185.65
|
| Rate for Payer: Aetna Medicare |
$1,696.32
|
| Rate for Payer: BCBS Complete |
$1,104.38
|
| Rate for Payer: BCBS MAPPO |
$1,631.08
|
| Rate for Payer: BCBS Trust/PPO |
$470.19
|
| Rate for Payer: BCN Commercial |
$2,636.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,631.08
|
| Rate for Payer: Cash Price |
$5,847.20
|
| Rate for Payer: Cash Price |
$5,847.20
|
| Rate for Payer: Cofinity Commercial |
$2,348.76
|
| Rate for Payer: Cofinity Commercial |
$2,185.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,631.08
|
| Rate for Payer: Mclaren Medicaid |
$1,051.79
|
| Rate for Payer: Meridian Medicaid |
$1,104.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,712.63
|
| Rate for Payer: PACE SWMI |
$1,631.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,631.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,051.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,116.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,774.49
|
| Rate for Payer: Priority Health Medicare |
$1,631.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,774.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,631.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,631.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,680.01
|
|
|
PR TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX
|
Professional
|
Both
|
$6,554.00
|
|
|
Service Code
|
HCPCS 55874
|
| Min. Negotiated Rate |
$103.73 |
| Max. Negotiated Rate |
$4,587.80 |
| Rate for Payer: Aetna Commercial |
$214.29
|
| Rate for Payer: Aetna Medicare |
$166.32
|
| Rate for Payer: BCBS Complete |
$108.92
|
| Rate for Payer: BCBS MAPPO |
$159.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,585.43
|
| Rate for Payer: BCN Commercial |
$4,253.94
|
| Rate for Payer: BCN Medicare Advantage |
$159.92
|
| Rate for Payer: Cash Price |
$5,243.20
|
| Rate for Payer: Cash Price |
$5,243.20
|
| Rate for Payer: Cofinity Commercial |
$230.28
|
| Rate for Payer: Cofinity Commercial |
$214.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.92
|
| Rate for Payer: Mclaren Medicaid |
$103.73
|
| Rate for Payer: Meridian Medicaid |
$108.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.92
|
| Rate for Payer: PACE SWMI |
$159.92
|
| Rate for Payer: PHP Medicare Advantage |
$159.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,587.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.00
|
| Rate for Payer: Priority Health Medicare |
$159.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.92
|
| Rate for Payer: UHC Medicare Advantage |
$164.72
|
|
|
PR TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ
|
Professional
|
Both
|
$2,668.00
|
|
|
Service Code
|
HCPCS 55875
|
| Min. Negotiated Rate |
$496.50 |
| Max. Negotiated Rate |
$2,345.12 |
| Rate for Payer: Aetna Commercial |
$1,017.09
|
| Rate for Payer: Aetna Medicare |
$789.38
|
| Rate for Payer: BCBS Complete |
$521.32
|
| Rate for Payer: BCBS MAPPO |
$759.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,345.12
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: BCN Medicare Advantage |
$759.02
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cofinity Commercial |
$1,092.99
|
| Rate for Payer: Cofinity Commercial |
$1,017.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.02
|
| Rate for Payer: Mclaren Medicaid |
$496.50
|
| Rate for Payer: Meridian Medicaid |
$521.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$796.97
|
| Rate for Payer: PACE SWMI |
$759.02
|
| Rate for Payer: PHP Medicare Advantage |
$759.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,867.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,243.90
|
| Rate for Payer: Priority Health Medicare |
$759.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,243.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.02
|
| Rate for Payer: UHC Medicare Advantage |
$781.79
|
|
|
PR TRANSPLANTATION TESTIS TO THIGH
|
Professional
|
Both
|
$1,392.00
|
|
|
Service Code
|
HCPCS 54680
|
| Min. Negotiated Rate |
$500.98 |
| Max. Negotiated Rate |
$2,125.35 |
| Rate for Payer: Aetna Commercial |
$1,030.63
|
| Rate for Payer: Aetna Medicare |
$799.90
|
| Rate for Payer: BCBS Complete |
$526.03
|
| Rate for Payer: BCBS MAPPO |
$769.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,125.35
|
| Rate for Payer: BCN Commercial |
$1,135.69
|
| Rate for Payer: BCN Medicare Advantage |
$769.13
|
| Rate for Payer: Cash Price |
$1,113.60
|
| Rate for Payer: Cash Price |
$1,113.60
|
| Rate for Payer: Cofinity Commercial |
$1,030.63
|
| Rate for Payer: Cofinity Commercial |
$1,107.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$769.13
|
| Rate for Payer: Mclaren Medicaid |
$500.98
|
| Rate for Payer: Meridian Medicaid |
$526.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$807.59
|
| Rate for Payer: PACE SWMI |
$769.13
|
| Rate for Payer: PHP Medicare Advantage |
$769.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,255.79
|
| Rate for Payer: Priority Health Medicare |
$769.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,255.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$769.13
|
| Rate for Payer: UHC Medicare Advantage |
$792.20
|
|
|
PR TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 27397
|
| Min. Negotiated Rate |
$591.71 |
| Max. Negotiated Rate |
$1,404.80 |
| Rate for Payer: Aetna Commercial |
$1,208.29
|
| Rate for Payer: Aetna Medicare |
$937.78
|
| Rate for Payer: BCBS Complete |
$621.30
|
| Rate for Payer: BCBS MAPPO |
$901.71
|
| Rate for Payer: BCBS Trust/PPO |
$629.21
|
| Rate for Payer: BCN Commercial |
$1,344.35
|
| Rate for Payer: BCN Medicare Advantage |
$901.71
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$1,298.46
|
| Rate for Payer: Cofinity Commercial |
$1,208.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$901.71
|
| Rate for Payer: Mclaren Medicaid |
$591.71
|
| Rate for Payer: Meridian Medicaid |
$621.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$946.80
|
| Rate for Payer: PACE SWMI |
$901.71
|
| Rate for Payer: PHP Medicare Advantage |
$901.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,404.80
|
| Rate for Payer: Priority Health Medicare |
$901.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,404.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$901.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$901.71
|
| Rate for Payer: UHC Medicare Advantage |
$928.76
|
|
|
PR TRANSPOSITION OVARY
|
Professional
|
Both
|
$1,434.00
|
|
|
Service Code
|
HCPCS 58825
|
| Min. Negotiated Rate |
$82.94 |
| Max. Negotiated Rate |
$1,042.35 |
| Rate for Payer: Aetna Commercial |
$944.51
|
| Rate for Payer: Aetna Medicare |
$733.05
|
| Rate for Payer: BCBS Complete |
$479.06
|
| Rate for Payer: BCBS MAPPO |
$704.86
|
| Rate for Payer: BCBS Trust/PPO |
$82.94
|
| Rate for Payer: BCN Commercial |
$1,042.35
|
| Rate for Payer: BCN Medicare Advantage |
$704.86
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cofinity Commercial |
$944.51
|
| Rate for Payer: Cofinity Commercial |
$1,015.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.86
|
| Rate for Payer: Mclaren Medicaid |
$456.25
|
| Rate for Payer: Meridian Medicaid |
$479.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$740.10
|
| Rate for Payer: PACE SWMI |
$704.86
|
| Rate for Payer: PHP Medicare Advantage |
$704.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,003.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,009.81
|
| Rate for Payer: Priority Health Medicare |
$704.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,009.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$704.86
|
| Rate for Payer: UHC Medicare Advantage |
$726.01
|
|
|
PR TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM
|
Professional
|
Both
|
$4,979.00
|
|
|
Service Code
|
HCPCS 61598
|
| Min. Negotiated Rate |
$1,835.31 |
| Max. Negotiated Rate |
$4,885.95 |
| Rate for Payer: Aetna Commercial |
$3,828.11
|
| Rate for Payer: Aetna Medicare |
$2,971.07
|
| Rate for Payer: BCBS Complete |
$1,936.14
|
| Rate for Payer: BCBS MAPPO |
$2,856.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,835.31
|
| Rate for Payer: BCN Commercial |
$4,216.80
|
| Rate for Payer: BCN Medicare Advantage |
$2,856.80
|
| Rate for Payer: Cash Price |
$3,983.20
|
| Rate for Payer: Cash Price |
$3,983.20
|
| Rate for Payer: Cofinity Commercial |
$4,113.79
|
| Rate for Payer: Cofinity Commercial |
$3,828.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,856.80
|
| Rate for Payer: Mclaren Medicaid |
$1,843.94
|
| Rate for Payer: Meridian Medicaid |
$1,936.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,999.64
|
| Rate for Payer: PACE SWMI |
$2,856.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,856.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,843.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,485.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,885.95
|
| Rate for Payer: Priority Health Medicare |
$2,856.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,885.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,856.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,856.80
|
| Rate for Payer: UHC Medicare Advantage |
$2,942.50
|
|
|
PR TRANSRECTAL DRAINAGE OF PELVIC ABSCESS
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 45000
|
| Min. Negotiated Rate |
$275.84 |
| Max. Negotiated Rate |
$2,674.78 |
| Rate for Payer: Aetna Commercial |
$565.47
|
| Rate for Payer: Aetna Medicare |
$438.87
|
| Rate for Payer: BCBS Complete |
$289.63
|
| Rate for Payer: BCBS MAPPO |
$421.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,674.78
|
| Rate for Payer: BCN Commercial |
$627.46
|
| Rate for Payer: BCN Medicare Advantage |
$421.99
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cofinity Commercial |
$565.47
|
| Rate for Payer: Cofinity Commercial |
$607.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.99
|
| Rate for Payer: Mclaren Medicaid |
$275.84
|
| Rate for Payer: Meridian Medicaid |
$289.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$443.09
|
| Rate for Payer: PACE SWMI |
$421.99
|
| Rate for Payer: PHP Medicare Advantage |
$421.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.95
|
| Rate for Payer: Priority Health Medicare |
$421.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$754.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.99
|
| Rate for Payer: UHC Medicare Advantage |
$434.65
|
|
|
PR TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 93293
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$525.66 |
| Rate for Payer: Aetna Commercial |
$57.66
|
| Rate for Payer: Aetna Medicare |
$44.75
|
| Rate for Payer: BCBS Complete |
$70.80
|
| Rate for Payer: BCBS MAPPO |
$43.03
|
| Rate for Payer: BCBS Trust/PPO |
$525.66
|
| Rate for Payer: BCN Commercial |
$66.46
|
| Rate for Payer: BCN Medicare Advantage |
$43.03
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$57.66
|
| Rate for Payer: Cofinity Commercial |
$61.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.18
|
| Rate for Payer: PACE SWMI |
$43.03
|
| Rate for Payer: PHP Medicare Advantage |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.31
|
| Rate for Payer: Priority Health Medicare |
$43.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.03
|
| Rate for Payer: UHC Medicare Advantage |
$44.32
|
|
|
PR TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV
|
Professional
|
Both
|
$6,126.00
|
|
|
Service Code
|
HCPCS 61595
|
| Min. Negotiated Rate |
$1,537.01 |
| Max. Negotiated Rate |
$4,288.20 |
| Rate for Payer: Aetna Commercial |
$3,165.16
|
| Rate for Payer: Aetna Medicare |
$2,456.54
|
| Rate for Payer: BCBS Complete |
$1,613.86
|
| Rate for Payer: BCBS MAPPO |
$2,362.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,960.52
|
| Rate for Payer: BCN Commercial |
$3,505.29
|
| Rate for Payer: BCN Medicare Advantage |
$2,362.06
|
| Rate for Payer: Cash Price |
$4,900.80
|
| Rate for Payer: Cash Price |
$4,900.80
|
| Rate for Payer: Cofinity Commercial |
$3,401.37
|
| Rate for Payer: Cofinity Commercial |
$3,165.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,362.06
|
| Rate for Payer: Mclaren Medicaid |
$1,537.01
|
| Rate for Payer: Meridian Medicaid |
$1,613.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,480.16
|
| Rate for Payer: PACE SWMI |
$2,362.06
|
| Rate for Payer: PHP Medicare Advantage |
$2,362.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,537.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,288.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,061.52
|
| Rate for Payer: Priority Health Medicare |
$2,362.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,061.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,362.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,362.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,432.92
|
|
|
PR TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR
|
Professional
|
Both
|
$2,118.00
|
|
|
Service Code
|
HCPCS 50770
|
| Min. Negotiated Rate |
$730.16 |
| Max. Negotiated Rate |
$2,761.42 |
| Rate for Payer: Aetna Commercial |
$1,506.09
|
| Rate for Payer: Aetna Medicare |
$1,168.91
|
| Rate for Payer: BCBS Complete |
$766.67
|
| Rate for Payer: BCBS MAPPO |
$1,123.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,761.42
|
| Rate for Payer: BCN Commercial |
$1,655.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,123.95
|
| Rate for Payer: Cash Price |
$1,694.40
|
| Rate for Payer: Cash Price |
$1,694.40
|
| Rate for Payer: Cofinity Commercial |
$1,618.49
|
| Rate for Payer: Cofinity Commercial |
$1,506.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,123.95
|
| Rate for Payer: Mclaren Medicaid |
$730.16
|
| Rate for Payer: Meridian Medicaid |
$766.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,180.15
|
| Rate for Payer: PACE SWMI |
$1,123.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,123.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$730.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,482.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.74
|
| Rate for Payer: Priority Health Medicare |
$1,123.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,830.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,123.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,123.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,157.67
|
|
|
PR TRANSURETHRAL INCISION PROSTATE
|
Professional
|
Both
|
$1,436.00
|
|
|
Service Code
|
HCPCS 52450
|
| Min. Negotiated Rate |
$356.60 |
| Max. Negotiated Rate |
$1,005.20 |
| Rate for Payer: Aetna Commercial |
$618.65
|
| Rate for Payer: Aetna Medicare |
$480.15
|
| Rate for Payer: BCBS Complete |
$574.40
|
| Rate for Payer: BCBS MAPPO |
$461.68
|
| Rate for Payer: BCBS Trust/PPO |
$356.60
|
| Rate for Payer: BCN Commercial |
$685.61
|
| Rate for Payer: BCN Medicare Advantage |
$461.68
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cofinity Commercial |
$618.65
|
| Rate for Payer: Cofinity Commercial |
$664.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$461.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$484.76
|
| Rate for Payer: PACE SWMI |
$461.68
|
| Rate for Payer: PHP Medicare Advantage |
$461.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,005.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$758.13
|
| Rate for Payer: Priority Health Medicare |
$461.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$758.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$461.68
|
| Rate for Payer: UHC Medicare Advantage |
$475.53
|
|
|
PR TRANSURETHRAL RESECTION BLADDER NECK
|
Professional
|
Both
|
$1,654.00
|
|
|
Service Code
|
HCPCS 52500
|
| Min. Negotiated Rate |
$315.67 |
| Max. Negotiated Rate |
$1,157.80 |
| Rate for Payer: Aetna Commercial |
$642.89
|
| Rate for Payer: Aetna Medicare |
$498.96
|
| Rate for Payer: BCBS Complete |
$331.45
|
| Rate for Payer: BCBS MAPPO |
$479.77
|
| Rate for Payer: BCBS Trust/PPO |
$652.45
|
| Rate for Payer: BCN Commercial |
$712.00
|
| Rate for Payer: BCN Medicare Advantage |
$479.77
|
| Rate for Payer: Cash Price |
$1,323.20
|
| Rate for Payer: Cash Price |
$1,323.20
|
| Rate for Payer: Cofinity Commercial |
$642.89
|
| Rate for Payer: Cofinity Commercial |
$690.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.77
|
| Rate for Payer: Mclaren Medicaid |
$315.67
|
| Rate for Payer: Meridian Medicaid |
$331.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$503.76
|
| Rate for Payer: PACE SWMI |
$479.77
|
| Rate for Payer: PHP Medicare Advantage |
$479.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$787.31
|
| Rate for Payer: Priority Health Medicare |
$479.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$479.77
|
| Rate for Payer: UHC Medicare Advantage |
$494.16
|
|
|
PR TRANSV AORTIC ARCH GRAFT W BYPASS
|
Professional
|
Both
|
$10,083.00
|
|
|
Service Code
|
HCPCS 33870
|
| Min. Negotiated Rate |
$4,033.20 |
| Max. Negotiated Rate |
$7,058.10 |
| Rate for Payer: BCBS Complete |
$4,033.20
|
| Rate for Payer: Cash Price |
$8,066.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,058.10
|
|
|
PR TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA
|
Professional
|
Both
|
$5,519.00
|
|
|
Service Code
|
HCPCS 33871
|
| Min. Negotiated Rate |
$972.07 |
| Max. Negotiated Rate |
$5,064.77 |
| Rate for Payer: Aetna Commercial |
$4,290.80
|
| Rate for Payer: Aetna Medicare |
$3,330.17
|
| Rate for Payer: BCBS Complete |
$2,134.07
|
| Rate for Payer: BCBS MAPPO |
$3,202.09
|
| Rate for Payer: BCBS Trust/PPO |
$972.07
|
| Rate for Payer: BCN Commercial |
$4,652.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,202.09
|
| Rate for Payer: Cash Price |
$4,415.20
|
| Rate for Payer: Cash Price |
$4,415.20
|
| Rate for Payer: Cofinity Commercial |
$4,290.80
|
| Rate for Payer: Cofinity Commercial |
$4,611.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,202.09
|
| Rate for Payer: Mclaren Medicaid |
$2,032.45
|
| Rate for Payer: Meridian Medicaid |
$2,134.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,362.19
|
| Rate for Payer: PACE SWMI |
$3,202.09
|
| Rate for Payer: PHP Medicare Advantage |
$3,202.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,032.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,863.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,064.77
|
| Rate for Payer: Priority Health Medicare |
$3,202.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,064.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,202.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,202.09
|
| Rate for Payer: UHC Medicare Advantage |
$3,298.15
|
|
|
PR TRAY FEE
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 00521
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.10
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION REQ ANES
|
Professional
|
Both
|
$1,286.00
|
|
|
Service Code
|
HCPCS 24605
|
| Min. Negotiated Rate |
$213.96 |
| Max. Negotiated Rate |
$900.20 |
| Rate for Payer: Aetna Commercial |
$633.50
|
| Rate for Payer: Aetna Medicare |
$491.67
|
| Rate for Payer: BCBS Complete |
$329.66
|
| Rate for Payer: BCBS MAPPO |
$472.76
|
| Rate for Payer: BCBS Trust/PPO |
$213.96
|
| Rate for Payer: BCN Commercial |
$711.51
|
| Rate for Payer: BCN Medicare Advantage |
$472.76
|
| Rate for Payer: Cash Price |
$1,028.80
|
| Rate for Payer: Cash Price |
$1,028.80
|
| Rate for Payer: Cofinity Commercial |
$680.77
|
| Rate for Payer: Cofinity Commercial |
$633.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.76
|
| Rate for Payer: Mclaren Medicaid |
$313.96
|
| Rate for Payer: Meridian Medicaid |
$329.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$496.40
|
| Rate for Payer: PACE SWMI |
$472.76
|
| Rate for Payer: PHP Medicare Advantage |
$472.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$743.51
|
| Rate for Payer: Priority Health Medicare |
$472.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$743.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$472.76
|
| Rate for Payer: UHC Medicare Advantage |
$486.94
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION W/O ANES
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 24600
|
| Min. Negotiated Rate |
$227.06 |
| Max. Negotiated Rate |
$567.84 |
| Rate for Payer: Aetna Commercial |
$459.10
|
| Rate for Payer: Aetna Medicare |
$356.31
|
| Rate for Payer: BCBS Complete |
$238.41
|
| Rate for Payer: BCBS MAPPO |
$342.61
|
| Rate for Payer: BCBS Trust/PPO |
$525.13
|
| Rate for Payer: BCN Commercial |
$567.84
|
| Rate for Payer: BCN Medicare Advantage |
$342.61
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$493.36
|
| Rate for Payer: Cofinity Commercial |
$459.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.61
|
| Rate for Payer: Mclaren Medicaid |
$227.06
|
| Rate for Payer: Meridian Medicaid |
$238.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$359.74
|
| Rate for Payer: PACE SWMI |
$342.61
|
| Rate for Payer: PHP Medicare Advantage |
$342.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.69
|
| Rate for Payer: Priority Health Medicare |
$342.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$536.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.61
|
| Rate for Payer: UHC Medicare Advantage |
$352.89
|
|
|
PR TRIAMCINOLONE ACETONIDE INJ
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J3301
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$7.00 |
| Rate for Payer: Aetna Commercial |
$1.35
|
| Rate for Payer: Aetna Medicare |
$1.05
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$1.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.55
|
| Rate for Payer: BCN Commercial |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$1.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$1.35
|
| Rate for Payer: Cofinity Commercial |
$1.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1.06
|
| Rate for Payer: PACE SWMI |
$1.00
|
| Rate for Payer: PHP Medicare Advantage |
$1.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.00
|
| Rate for Payer: Priority Health Medicare |
$1.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.00
|
| Rate for Payer: UHC Medicare Advantage |
$1.04
|
|
|
PR TRIMETHOBENZAMIDE HCL INJ
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS J3250
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$64.86 |
| Rate for Payer: Aetna Commercial |
$60.35
|
| Rate for Payer: Aetna Medicare |
$46.84
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$45.04
|
| Rate for Payer: BCBS Trust/PPO |
$48.74
|
| Rate for Payer: BCN Commercial |
$45.78
|
| Rate for Payer: BCN Medicare Advantage |
$45.04
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$60.35
|
| Rate for Payer: Cofinity Commercial |
$64.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.29
|
| Rate for Payer: PACE SWMI |
$45.04
|
| Rate for Payer: PHP Medicare Advantage |
$45.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health Medicare |
$45.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.04
|
| Rate for Payer: UHC Medicare Advantage |
$46.39
|
|
|
PR TRIMMING NONDYSTROPHIC NAILS ANY NUMBER
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 11719
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$9.86
|
| Rate for Payer: Aetna Medicare |
$7.65
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$7.36
|
| Rate for Payer: BCBS Trust/PPO |
$12.00
|
| Rate for Payer: BCN Commercial |
$16.49
|
| Rate for Payer: BCN Medicare Advantage |
$7.36
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$10.60
|
| Rate for Payer: Cofinity Commercial |
$9.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.73
|
| Rate for Payer: PACE SWMI |
$7.36
|
| Rate for Payer: PHP Medicare Advantage |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.05
|
| Rate for Payer: Priority Health Medicare |
$7.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.36
|
| Rate for Payer: UHC Medicare Advantage |
$7.58
|
|
|
PR TRIM NAIL(S)
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G0127
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$1,929.35 |
| Rate for Payer: Aetna Commercial |
$9.86
|
| Rate for Payer: Aetna Medicare |
$7.65
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$7.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,929.35
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: BCN Medicare Advantage |
$7.36
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$9.86
|
| Rate for Payer: Cofinity Commercial |
$10.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.73
|
| Rate for Payer: PACE SWMI |
$7.36
|
| Rate for Payer: PHP Medicare Advantage |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.05
|
| Rate for Payer: Priority Health Medicare |
$7.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.36
|
| Rate for Payer: UHC Medicare Advantage |
$7.58
|
|
