PR URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX
|
Professional
|
Both
|
$1,494.00
|
|
Service Code
|
HCPCS 53400
|
Min. Negotiated Rate |
$509.07 |
Max. Negotiated Rate |
$2,001.20 |
Rate for Payer: Aetna Commercial |
$1,047.02
|
Rate for Payer: Aetna Medicare |
$812.61
|
Rate for Payer: BCBS Complete |
$534.52
|
Rate for Payer: BCBS MAPPO |
$781.36
|
Rate for Payer: BCBS Trust/PPO |
$2,001.20
|
Rate for Payer: BCN Commercial |
$1,154.25
|
Rate for Payer: BCN Medicare Advantage |
$781.36
|
Rate for Payer: Cash Price |
$1,195.20
|
Rate for Payer: Cash Price |
$1,195.20
|
Rate for Payer: Cofinity Commercial |
$1,047.02
|
Rate for Payer: Cofinity Commercial |
$1,125.16
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.36
|
Rate for Payer: Mclaren Medicaid |
$509.07
|
Rate for Payer: Meridian Medicaid |
$534.52
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$820.43
|
Rate for Payer: PACE SWMI |
$781.36
|
Rate for Payer: PHP Medicare Advantage |
$781.36
|
Rate for Payer: Priority Health Choice Medicaid |
$509.07
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,045.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,276.33
|
Rate for Payer: Priority Health Medicare |
$781.36
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,276.33
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$781.36
|
Rate for Payer: UHC Dual Complete DSNP |
$781.36
|
Rate for Payer: UHC Medicare Advantage |
$804.80
|
|
PR URETHROPLASTY 2ND STAGE W/URINARY DIVERSION
|
Professional
|
Both
|
$1,778.00
|
|
Service Code
|
HCPCS 53405
|
Min. Negotiated Rate |
$554.87 |
Max. Negotiated Rate |
$2,435.99 |
Rate for Payer: Aetna Commercial |
$1,142.51
|
Rate for Payer: Aetna Medicare |
$886.72
|
Rate for Payer: BCBS Complete |
$582.61
|
Rate for Payer: BCBS MAPPO |
$852.62
|
Rate for Payer: BCBS Trust/PPO |
$2,435.99
|
Rate for Payer: BCN Commercial |
$1,258.34
|
Rate for Payer: BCN Medicare Advantage |
$852.62
|
Rate for Payer: Cash Price |
$1,422.40
|
Rate for Payer: Cash Price |
$1,422.40
|
Rate for Payer: Cofinity Commercial |
$1,227.77
|
Rate for Payer: Cofinity Commercial |
$1,142.51
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$852.62
|
Rate for Payer: Mclaren Medicaid |
$554.87
|
Rate for Payer: Meridian Medicaid |
$582.61
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$895.25
|
Rate for Payer: PACE SWMI |
$852.62
|
Rate for Payer: PHP Medicare Advantage |
$852.62
|
Rate for Payer: Priority Health Choice Medicaid |
$554.87
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,244.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,391.43
|
Rate for Payer: Priority Health Medicare |
$852.62
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,391.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$852.62
|
Rate for Payer: UHC Dual Complete DSNP |
$852.62
|
Rate for Payer: UHC Medicare Advantage |
$878.20
|
|
PR URETHROPLASTY RCNSTJ FEMALE URETHRA
|
Professional
|
Both
|
$1,729.00
|
|
Service Code
|
HCPCS 53430
|
Min. Negotiated Rate |
$619.40 |
Max. Negotiated Rate |
$2,049.80 |
Rate for Payer: Aetna Commercial |
$1,278.83
|
Rate for Payer: Aetna Medicare |
$992.52
|
Rate for Payer: BCBS Complete |
$650.37
|
Rate for Payer: BCBS MAPPO |
$954.35
|
Rate for Payer: BCBS Trust/PPO |
$2,049.80
|
Rate for Payer: BCN Commercial |
$1,406.42
|
Rate for Payer: BCN Medicare Advantage |
$954.35
|
Rate for Payer: Cash Price |
$1,383.20
|
Rate for Payer: Cash Price |
$1,383.20
|
Rate for Payer: Cofinity Commercial |
$1,374.26
|
Rate for Payer: Cofinity Commercial |
$1,278.83
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$954.35
|
Rate for Payer: Mclaren Medicaid |
$619.40
|
Rate for Payer: Meridian Medicaid |
$650.37
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,002.07
|
Rate for Payer: PACE SWMI |
$954.35
|
Rate for Payer: PHP Medicare Advantage |
$954.35
|
Rate for Payer: Priority Health Choice Medicaid |
$619.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,210.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,555.14
|
Rate for Payer: Priority Health Medicare |
$954.35
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,555.14
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$954.35
|
Rate for Payer: UHC Dual Complete DSNP |
$954.35
|
Rate for Payer: UHC Medicare Advantage |
$982.98
|
|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE
|
Professional
|
Both
|
$958.00
|
|
Service Code
|
HCPCS 53502
|
Min. Negotiated Rate |
$311.19 |
Max. Negotiated Rate |
$777.04 |
Rate for Payer: Aetna Commercial |
$635.59
|
Rate for Payer: Aetna Medicare |
$493.29
|
Rate for Payer: BCBS Complete |
$326.75
|
Rate for Payer: BCBS MAPPO |
$474.32
|
Rate for Payer: BCBS Trust/PPO |
$701.05
|
Rate for Payer: BCN Commercial |
$702.72
|
Rate for Payer: BCN Medicare Advantage |
$474.32
|
Rate for Payer: Cash Price |
$766.40
|
Rate for Payer: Cash Price |
$766.40
|
Rate for Payer: Cofinity Commercial |
$683.02
|
Rate for Payer: Cofinity Commercial |
$635.59
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.32
|
Rate for Payer: Mclaren Medicaid |
$311.19
|
Rate for Payer: Meridian Medicaid |
$326.75
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$498.04
|
Rate for Payer: PACE SWMI |
$474.32
|
Rate for Payer: PHP Medicare Advantage |
$474.32
|
Rate for Payer: Priority Health Choice Medicaid |
$311.19
|
Rate for Payer: Priority Health Cigna Priority Health |
$670.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$777.04
|
Rate for Payer: Priority Health Medicare |
$474.32
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$777.04
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$474.32
|
Rate for Payer: UHC Dual Complete DSNP |
$474.32
|
Rate for Payer: UHC Medicare Advantage |
$488.55
|
|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE
|
Professional
|
Both
|
$905.00
|
|
Service Code
|
HCPCS 53505
|
Min. Negotiated Rate |
$288.98 |
Max. Negotiated Rate |
$776.50 |
Rate for Payer: Aetna Commercial |
$635.17
|
Rate for Payer: Aetna Medicare |
$492.97
|
Rate for Payer: BCBS Complete |
$326.53
|
Rate for Payer: BCBS MAPPO |
$474.01
|
Rate for Payer: BCBS Trust/PPO |
$288.98
|
Rate for Payer: BCN Commercial |
$702.23
|
Rate for Payer: BCN Medicare Advantage |
$474.01
|
Rate for Payer: Cash Price |
$724.00
|
Rate for Payer: Cash Price |
$724.00
|
Rate for Payer: Cofinity Commercial |
$635.17
|
Rate for Payer: Cofinity Commercial |
$682.57
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.01
|
Rate for Payer: Mclaren Medicaid |
$310.98
|
Rate for Payer: Meridian Medicaid |
$326.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$497.71
|
Rate for Payer: PACE SWMI |
$474.01
|
Rate for Payer: PHP Medicare Advantage |
$474.01
|
Rate for Payer: Priority Health Choice Medicaid |
$310.98
|
Rate for Payer: Priority Health Cigna Priority Health |
$633.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$776.50
|
Rate for Payer: Priority Health Medicare |
$474.01
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$776.50
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$474.01
|
Rate for Payer: UHC Dual Complete DSNP |
$474.01
|
Rate for Payer: UHC Medicare Advantage |
$488.23
|
|
PR URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA
|
Professional
|
Both
|
$542.00
|
|
Service Code
|
HCPCS 53010
|
Min. Negotiated Rate |
$191.27 |
Max. Negotiated Rate |
$476.06 |
Rate for Payer: Aetna Commercial |
$386.40
|
Rate for Payer: Aetna Medicare |
$299.89
|
Rate for Payer: BCBS Complete |
$200.83
|
Rate for Payer: BCBS MAPPO |
$288.36
|
Rate for Payer: BCBS Trust/PPO |
$359.24
|
Rate for Payer: BCN Commercial |
$430.52
|
Rate for Payer: BCN Medicare Advantage |
$288.36
|
Rate for Payer: Cash Price |
$433.60
|
Rate for Payer: Cash Price |
$433.60
|
Rate for Payer: Cofinity Commercial |
$386.40
|
Rate for Payer: Cofinity Commercial |
$415.24
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.36
|
Rate for Payer: Mclaren Medicaid |
$191.27
|
Rate for Payer: Meridian Medicaid |
$200.83
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.78
|
Rate for Payer: PACE SWMI |
$288.36
|
Rate for Payer: PHP Medicare Advantage |
$288.36
|
Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$379.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$476.06
|
Rate for Payer: Priority Health Medicare |
$288.36
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$476.06
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$288.36
|
Rate for Payer: UHC Dual Complete DSNP |
$288.36
|
Rate for Payer: UHC Medicare Advantage |
$297.01
|
|
PR URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,284.00
|
|
Service Code
|
HCPCS 50650
|
Min. Negotiated Rate |
$659.24 |
Max. Negotiated Rate |
$2,298.80 |
Rate for Payer: Aetna Commercial |
$1,355.97
|
Rate for Payer: Aetna Medicare |
$1,052.40
|
Rate for Payer: BCBS Complete |
$692.20
|
Rate for Payer: BCBS MAPPO |
$1,011.92
|
Rate for Payer: BCBS Trust/PPO |
$809.36
|
Rate for Payer: BCN Commercial |
$1,491.44
|
Rate for Payer: BCN Medicare Advantage |
$1,011.92
|
Rate for Payer: Cash Price |
$2,627.20
|
Rate for Payer: Cash Price |
$2,627.20
|
Rate for Payer: Cofinity Commercial |
$1,355.97
|
Rate for Payer: Cofinity Commercial |
$1,457.16
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,011.92
|
Rate for Payer: Mclaren Medicaid |
$659.24
|
Rate for Payer: Meridian Medicaid |
$692.20
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,062.52
|
Rate for Payer: PACE SWMI |
$1,011.92
|
Rate for Payer: PHP Medicare Advantage |
$1,011.92
|
Rate for Payer: Priority Health Choice Medicaid |
$659.24
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,298.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,649.18
|
Rate for Payer: Priority Health Medicare |
$1,011.92
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,649.18
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,011.92
|
Rate for Payer: UHC Dual Complete DSNP |
$1,011.92
|
Rate for Payer: UHC Medicare Advantage |
$1,042.28
|
|
PR URINARY LEG OR ABDOMEN BAG
|
Professional
|
Both
|
$8.00
|
|
Service Code
|
HCPCS A4358
|
Min. Negotiated Rate |
$3.20 |
Max. Negotiated Rate |
$6.46 |
Rate for Payer: Aetna Commercial |
$5.46
|
Rate for Payer: BCBS Complete |
$3.20
|
Rate for Payer: BCN Commercial |
$6.46
|
Rate for Payer: Cash Price |
$6.40
|
Rate for Payer: Cash Price |
$6.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
|
PR URTP W/TUBULARIZATION POST URT&/LWR BLDR
|
Professional
|
Both
|
$2,163.00
|
|
Service Code
|
HCPCS 53431
|
Min. Negotiated Rate |
$730.16 |
Max. Negotiated Rate |
$2,997.57 |
Rate for Payer: Aetna Commercial |
$1,506.35
|
Rate for Payer: Aetna Medicare |
$1,169.11
|
Rate for Payer: BCBS Complete |
$766.67
|
Rate for Payer: BCBS MAPPO |
$1,124.14
|
Rate for Payer: BCBS Trust/PPO |
$2,997.57
|
Rate for Payer: BCN Commercial |
$1,656.13
|
Rate for Payer: BCN Medicare Advantage |
$1,124.14
|
Rate for Payer: Cash Price |
$1,730.40
|
Rate for Payer: Cash Price |
$1,730.40
|
Rate for Payer: Cofinity Commercial |
$1,618.76
|
Rate for Payer: Cofinity Commercial |
$1,506.35
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,124.14
|
Rate for Payer: Mclaren Medicaid |
$730.16
|
Rate for Payer: Meridian Medicaid |
$766.67
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,180.35
|
Rate for Payer: PACE SWMI |
$1,124.14
|
Rate for Payer: PHP Medicare Advantage |
$1,124.14
|
Rate for Payer: Priority Health Choice Medicaid |
$730.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,514.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,831.28
|
Rate for Payer: Priority Health Medicare |
$1,124.14
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,831.28
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,124.14
|
Rate for Payer: UHC Dual Complete DSNP |
$1,124.14
|
Rate for Payer: UHC Medicare Advantage |
$1,157.86
|
|
PR URTROLITHOTOMY MIDDLE ONE-THIRD URETER
|
Professional
|
Both
|
$1,594.00
|
|
Service Code
|
HCPCS 50620
|
Min. Negotiated Rate |
$572.97 |
Max. Negotiated Rate |
$1,436.81 |
Rate for Payer: Aetna Commercial |
$1,181.05
|
Rate for Payer: Aetna Medicare |
$916.64
|
Rate for Payer: BCBS Complete |
$601.62
|
Rate for Payer: BCBS MAPPO |
$881.38
|
Rate for Payer: BCBS Trust/PPO |
$1,273.73
|
Rate for Payer: BCN Commercial |
$1,299.39
|
Rate for Payer: BCN Medicare Advantage |
$881.38
|
Rate for Payer: Cash Price |
$1,275.20
|
Rate for Payer: Cash Price |
$1,275.20
|
Rate for Payer: Cofinity Commercial |
$1,181.05
|
Rate for Payer: Cofinity Commercial |
$1,269.19
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.38
|
Rate for Payer: Mclaren Medicaid |
$572.97
|
Rate for Payer: Meridian Medicaid |
$601.62
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$925.45
|
Rate for Payer: PACE SWMI |
$881.38
|
Rate for Payer: PHP Medicare Advantage |
$881.38
|
Rate for Payer: Priority Health Choice Medicaid |
$572.97
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,115.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,436.81
|
Rate for Payer: Priority Health Medicare |
$881.38
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,436.81
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$881.38
|
Rate for Payer: UHC Dual Complete DSNP |
$881.38
|
Rate for Payer: UHC Medicare Advantage |
$907.82
|
|
PR URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP
|
Professional
|
Both
|
$4,561.00
|
|
Service Code
|
HCPCS 50785
|
Min. Negotiated Rate |
$768.08 |
Max. Negotiated Rate |
$3,192.70 |
Rate for Payer: Aetna Commercial |
$1,590.65
|
Rate for Payer: Aetna Medicare |
$1,234.53
|
Rate for Payer: BCBS Complete |
$806.48
|
Rate for Payer: BCBS MAPPO |
$1,187.05
|
Rate for Payer: BCBS Trust/PPO |
$3,101.12
|
Rate for Payer: BCN Commercial |
$1,747.51
|
Rate for Payer: BCN Medicare Advantage |
$1,187.05
|
Rate for Payer: Cash Price |
$3,648.80
|
Rate for Payer: Cash Price |
$3,648.80
|
Rate for Payer: Cofinity Commercial |
$1,709.35
|
Rate for Payer: Cofinity Commercial |
$1,590.65
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,187.05
|
Rate for Payer: Mclaren Medicaid |
$768.08
|
Rate for Payer: Meridian Medicaid |
$806.48
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,246.40
|
Rate for Payer: PACE SWMI |
$1,187.05
|
Rate for Payer: PHP Medicare Advantage |
$1,187.05
|
Rate for Payer: Priority Health Choice Medicaid |
$768.08
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,192.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,932.33
|
Rate for Payer: Priority Health Medicare |
$1,187.05
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,932.33
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,187.05
|
Rate for Payer: UHC Dual Complete DSNP |
$1,187.05
|
Rate for Payer: UHC Medicare Advantage |
$1,222.66
|
|
PR URTT/URTS XTRNL SPX PENDULOUS URETHRA
|
Professional
|
Both
|
$275.00
|
|
Service Code
|
HCPCS 53000
|
Min. Negotiated Rate |
$95.21 |
Max. Negotiated Rate |
$283.70 |
Rate for Payer: Aetna Commercial |
$193.04
|
Rate for Payer: Aetna Medicare |
$149.82
|
Rate for Payer: BCBS Complete |
$99.97
|
Rate for Payer: BCBS MAPPO |
$144.06
|
Rate for Payer: BCBS Trust/PPO |
$283.70
|
Rate for Payer: BCN Commercial |
$214.53
|
Rate for Payer: BCN Medicare Advantage |
$144.06
|
Rate for Payer: Cash Price |
$220.00
|
Rate for Payer: Cash Price |
$220.00
|
Rate for Payer: Cofinity Commercial |
$193.04
|
Rate for Payer: Cofinity Commercial |
$207.45
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.06
|
Rate for Payer: Mclaren Medicaid |
$95.21
|
Rate for Payer: Meridian Medicaid |
$99.97
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$151.26
|
Rate for Payer: PACE SWMI |
$144.06
|
Rate for Payer: PHP Medicare Advantage |
$144.06
|
Rate for Payer: Priority Health Choice Medicaid |
$95.21
|
Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.21
|
Rate for Payer: Priority Health Medicare |
$144.06
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$237.21
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$144.06
|
Rate for Payer: UHC Dual Complete DSNP |
$144.06
|
Rate for Payer: UHC Medicare Advantage |
$148.38
|
|
PR USE OF ECHO CONTRAST AGENT DURING STRESS ECHO
|
Professional
|
Both
|
$64.00
|
|
Service Code
|
HCPCS 93352
|
Min. Negotiated Rate |
$25.60 |
Max. Negotiated Rate |
$1,312.83 |
Rate for Payer: Aetna Commercial |
$42.69
|
Rate for Payer: Aetna Medicare |
$33.13
|
Rate for Payer: BCBS Complete |
$25.60
|
Rate for Payer: BCBS MAPPO |
$31.86
|
Rate for Payer: BCBS Trust/PPO |
$1,312.83
|
Rate for Payer: BCN Commercial |
$49.36
|
Rate for Payer: BCN Medicare Advantage |
$31.86
|
Rate for Payer: Cash Price |
$51.20
|
Rate for Payer: Cash Price |
$51.20
|
Rate for Payer: Cofinity Commercial |
$42.69
|
Rate for Payer: Cofinity Commercial |
$45.88
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.86
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.45
|
Rate for Payer: PACE SWMI |
$31.86
|
Rate for Payer: PHP Medicare Advantage |
$31.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$44.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.77
|
Rate for Payer: Priority Health Medicare |
$31.86
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$47.77
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$31.86
|
Rate for Payer: UHC Dual Complete DSNP |
$31.86
|
Rate for Payer: UHC Medicare Advantage |
$32.82
|
|
PR USE VERTICAL ELECTRODES
|
Professional
|
Both
|
$22.00
|
|
Service Code
|
HCPCS 92547
|
Min. Negotiated Rate |
$8.80 |
Max. Negotiated Rate |
$1,085.66 |
Rate for Payer: Aetna Commercial |
$13.24
|
Rate for Payer: Aetna Medicare |
$10.28
|
Rate for Payer: BCBS Complete |
$8.80
|
Rate for Payer: BCBS MAPPO |
$9.88
|
Rate for Payer: BCBS Trust/PPO |
$1,085.66
|
Rate for Payer: BCN Commercial |
$15.64
|
Rate for Payer: BCN Medicare Advantage |
$9.88
|
Rate for Payer: Cash Price |
$17.60
|
Rate for Payer: Cash Price |
$17.60
|
Rate for Payer: Cofinity Commercial |
$14.23
|
Rate for Payer: Cofinity Commercial |
$13.24
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.88
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.37
|
Rate for Payer: PACE SWMI |
$9.88
|
Rate for Payer: PHP Medicare Advantage |
$9.88
|
Rate for Payer: Priority Health Cigna Priority Health |
$15.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.37
|
Rate for Payer: Priority Health Medicare |
$9.88
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$9.88
|
Rate for Payer: UHC Dual Complete DSNP |
$9.88
|
Rate for Payer: UHC Medicare Advantage |
$10.18
|
|
PR UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE
|
Professional
|
Both
|
$770.00
|
|
Service Code
|
HCPCS 59870
|
Min. Negotiated Rate |
$347.62 |
Max. Negotiated Rate |
$794.10 |
Rate for Payer: Aetna Commercial |
$713.54
|
Rate for Payer: Aetna Medicare |
$553.79
|
Rate for Payer: BCBS Complete |
$365.00
|
Rate for Payer: BCBS MAPPO |
$532.49
|
Rate for Payer: BCBS Trust/PPO |
$547.32
|
Rate for Payer: BCN Commercial |
$794.10
|
Rate for Payer: BCN Medicare Advantage |
$532.49
|
Rate for Payer: Cash Price |
$616.00
|
Rate for Payer: Cash Price |
$616.00
|
Rate for Payer: Cofinity Commercial |
$766.79
|
Rate for Payer: Cofinity Commercial |
$713.54
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.49
|
Rate for Payer: Mclaren Medicaid |
$347.62
|
Rate for Payer: Meridian Medicaid |
$365.00
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$559.11
|
Rate for Payer: PACE SWMI |
$532.49
|
Rate for Payer: PHP Medicare Advantage |
$532.49
|
Rate for Payer: Priority Health Choice Medicaid |
$347.62
|
Rate for Payer: Priority Health Cigna Priority Health |
$539.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$767.29
|
Rate for Payer: Priority Health Medicare |
$532.49
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$767.29
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$532.49
|
Rate for Payer: UHC Dual Complete DSNP |
$532.49
|
Rate for Payer: UHC Medicare Advantage |
$548.46
|
|
PR UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX
|
Professional
|
Both
|
$847.00
|
|
Service Code
|
HCPCS 58400
|
Min. Negotiated Rate |
$298.84 |
Max. Negotiated Rate |
$680.73 |
Rate for Payer: Aetna Commercial |
$613.05
|
Rate for Payer: Aetna Medicare |
$475.80
|
Rate for Payer: BCBS Complete |
$313.78
|
Rate for Payer: BCBS MAPPO |
$457.50
|
Rate for Payer: BCBS Trust/PPO |
$568.45
|
Rate for Payer: BCN Commercial |
$680.73
|
Rate for Payer: BCN Medicare Advantage |
$457.50
|
Rate for Payer: Cash Price |
$677.60
|
Rate for Payer: Cash Price |
$677.60
|
Rate for Payer: Cofinity Commercial |
$658.80
|
Rate for Payer: Cofinity Commercial |
$613.05
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.50
|
Rate for Payer: Mclaren Medicaid |
$298.84
|
Rate for Payer: Meridian Medicaid |
$313.78
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$480.38
|
Rate for Payer: PACE SWMI |
$457.50
|
Rate for Payer: PHP Medicare Advantage |
$457.50
|
Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
Rate for Payer: Priority Health Cigna Priority Health |
$592.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.48
|
Rate for Payer: Priority Health Medicare |
$457.50
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$659.48
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$457.50
|
Rate for Payer: UHC Dual Complete DSNP |
$457.50
|
Rate for Payer: UHC Medicare Advantage |
$471.22
|
|
PR U-TUBE HEPATICOENTEROSTOMY
|
Professional
|
Both
|
$2,680.00
|
|
Service Code
|
HCPCS 47802
|
Min. Negotiated Rate |
$974.26 |
Max. Negotiated Rate |
$3,097.42 |
Rate for Payer: Aetna Commercial |
$2,032.20
|
Rate for Payer: Aetna Medicare |
$1,577.23
|
Rate for Payer: BCBS Complete |
$1,022.97
|
Rate for Payer: BCBS MAPPO |
$1,516.57
|
Rate for Payer: BCBS Trust/PPO |
$3,097.42
|
Rate for Payer: BCN Commercial |
$2,226.41
|
Rate for Payer: BCN Medicare Advantage |
$1,516.57
|
Rate for Payer: Cash Price |
$2,144.00
|
Rate for Payer: Cash Price |
$2,144.00
|
Rate for Payer: Cofinity Commercial |
$2,032.20
|
Rate for Payer: Cofinity Commercial |
$2,183.86
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,516.57
|
Rate for Payer: Mclaren Medicaid |
$974.26
|
Rate for Payer: Meridian Medicaid |
$1,022.97
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,592.40
|
Rate for Payer: PACE SWMI |
$1,516.57
|
Rate for Payer: PHP Medicare Advantage |
$1,516.57
|
Rate for Payer: Priority Health Choice Medicaid |
$974.26
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,876.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,678.80
|
Rate for Payer: Priority Health Medicare |
$1,516.57
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,678.80
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,516.57
|
Rate for Payer: UHC Dual Complete DSNP |
$1,516.57
|
Rate for Payer: UHC Medicare Advantage |
$1,562.07
|
|
PR UVULECTOMY EXCISION UVULA
|
Professional
|
Both
|
$562.00
|
|
Service Code
|
HCPCS 42140
|
Min. Negotiated Rate |
$105.44 |
Max. Negotiated Rate |
$596.98 |
Rate for Payer: Aetna Commercial |
$210.62
|
Rate for Payer: Aetna Medicare |
$163.47
|
Rate for Payer: BCBS Complete |
$110.71
|
Rate for Payer: BCBS MAPPO |
$157.18
|
Rate for Payer: BCBS Trust/PPO |
$596.98
|
Rate for Payer: BCN Commercial |
$461.32
|
Rate for Payer: BCN Medicare Advantage |
$157.18
|
Rate for Payer: Cash Price |
$449.60
|
Rate for Payer: Cash Price |
$449.60
|
Rate for Payer: Cofinity Commercial |
$226.34
|
Rate for Payer: Cofinity Commercial |
$210.62
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.18
|
Rate for Payer: Mclaren Medicaid |
$105.44
|
Rate for Payer: Meridian Medicaid |
$110.71
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$165.04
|
Rate for Payer: PACE SWMI |
$157.18
|
Rate for Payer: PHP Medicare Advantage |
$157.18
|
Rate for Payer: Priority Health Choice Medicaid |
$105.44
|
Rate for Payer: Priority Health Cigna Priority Health |
$393.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.93
|
Rate for Payer: Priority Health Medicare |
$157.18
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$286.93
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$157.18
|
Rate for Payer: UHC Dual Complete DSNP |
$157.18
|
Rate for Payer: UHC Medicare Advantage |
$161.90
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY
|
Professional
|
Both
|
$3,063.00
|
|
Service Code
|
HCPCS 58291
|
Min. Negotiated Rate |
$190.19 |
Max. Negotiated Rate |
$2,144.10 |
Rate for Payer: Aetna Commercial |
$1,659.92
|
Rate for Payer: Aetna Medicare |
$1,288.30
|
Rate for Payer: BCBS Complete |
$836.67
|
Rate for Payer: BCBS MAPPO |
$1,238.75
|
Rate for Payer: BCBS Trust/PPO |
$190.19
|
Rate for Payer: BCN Commercial |
$1,823.26
|
Rate for Payer: BCN Medicare Advantage |
$1,238.75
|
Rate for Payer: Cash Price |
$2,450.40
|
Rate for Payer: Cash Price |
$2,450.40
|
Rate for Payer: Cofinity Commercial |
$1,783.80
|
Rate for Payer: Cofinity Commercial |
$1,659.92
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,238.75
|
Rate for Payer: Mclaren Medicaid |
$796.83
|
Rate for Payer: Meridian Medicaid |
$836.67
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,300.69
|
Rate for Payer: PACE SWMI |
$1,238.75
|
Rate for Payer: PHP Medicare Advantage |
$1,238.75
|
Rate for Payer: Priority Health Choice Medicaid |
$796.83
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,144.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,766.34
|
Rate for Payer: Priority Health Medicare |
$1,238.75
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,766.34
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,238.75
|
Rate for Payer: UHC Dual Complete DSNP |
$1,238.75
|
Rate for Payer: UHC Medicare Advantage |
$1,275.91
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE
|
Professional
|
Both
|
$3,389.00
|
|
Service Code
|
HCPCS 58292
|
Min. Negotiated Rate |
$213.96 |
Max. Negotiated Rate |
$2,372.30 |
Rate for Payer: Aetna Commercial |
$1,749.93
|
Rate for Payer: Aetna Medicare |
$1,358.16
|
Rate for Payer: BCBS Complete |
$881.63
|
Rate for Payer: BCBS MAPPO |
$1,305.92
|
Rate for Payer: BCBS Trust/PPO |
$213.96
|
Rate for Payer: BCN Commercial |
$1,921.48
|
Rate for Payer: BCN Medicare Advantage |
$1,305.92
|
Rate for Payer: Cash Price |
$2,711.20
|
Rate for Payer: Cash Price |
$2,711.20
|
Rate for Payer: Cofinity Commercial |
$1,880.52
|
Rate for Payer: Cofinity Commercial |
$1,749.93
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,305.92
|
Rate for Payer: Mclaren Medicaid |
$839.65
|
Rate for Payer: Meridian Medicaid |
$881.63
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,371.22
|
Rate for Payer: PACE SWMI |
$1,305.92
|
Rate for Payer: PHP Medicare Advantage |
$1,305.92
|
Rate for Payer: Priority Health Choice Medicaid |
$839.65
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,372.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,861.50
|
Rate for Payer: Priority Health Medicare |
$1,305.92
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,861.50
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,305.92
|
Rate for Payer: UHC Dual Complete DSNP |
$1,305.92
|
Rate for Payer: UHC Medicare Advantage |
$1,345.10
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE&/OVARY
|
Professional
|
Both
|
$2,915.00
|
|
Service Code
|
HCPCS 58262
|
Min. Negotiated Rate |
$266.26 |
Max. Negotiated Rate |
$2,040.50 |
Rate for Payer: Aetna Commercial |
$1,234.10
|
Rate for Payer: Aetna Medicare |
$957.81
|
Rate for Payer: BCBS Complete |
$625.33
|
Rate for Payer: BCBS MAPPO |
$920.97
|
Rate for Payer: BCBS Trust/PPO |
$266.26
|
Rate for Payer: BCN Commercial |
$1,359.01
|
Rate for Payer: BCN Medicare Advantage |
$920.97
|
Rate for Payer: Cash Price |
$2,332.00
|
Rate for Payer: Cash Price |
$2,332.00
|
Rate for Payer: Cofinity Commercial |
$1,326.20
|
Rate for Payer: Cofinity Commercial |
$1,234.10
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$920.97
|
Rate for Payer: Mclaren Medicaid |
$595.55
|
Rate for Payer: Meridian Medicaid |
$625.33
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$967.02
|
Rate for Payer: PACE SWMI |
$920.97
|
Rate for Payer: PHP Medicare Advantage |
$920.97
|
Rate for Payer: Priority Health Choice Medicaid |
$595.55
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,040.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,316.59
|
Rate for Payer: Priority Health Medicare |
$920.97
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,316.59
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$920.97
|
Rate for Payer: UHC Dual Complete DSNP |
$920.97
|
Rate for Payer: UHC Medicare Advantage |
$948.60
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL
|
Professional
|
Both
|
$3,181.00
|
|
Service Code
|
HCPCS 58263
|
Min. Negotiated Rate |
$192.83 |
Max. Negotiated Rate |
$2,226.70 |
Rate for Payer: Aetna Commercial |
$1,324.60
|
Rate for Payer: Aetna Medicare |
$1,028.05
|
Rate for Payer: BCBS Complete |
$670.06
|
Rate for Payer: BCBS MAPPO |
$988.51
|
Rate for Payer: BCBS Trust/PPO |
$192.83
|
Rate for Payer: BCN Commercial |
$1,457.73
|
Rate for Payer: BCN Medicare Advantage |
$988.51
|
Rate for Payer: Cash Price |
$2,544.80
|
Rate for Payer: Cash Price |
$2,544.80
|
Rate for Payer: Cofinity Commercial |
$1,324.60
|
Rate for Payer: Cofinity Commercial |
$1,423.45
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$988.51
|
Rate for Payer: Mclaren Medicaid |
$638.15
|
Rate for Payer: Meridian Medicaid |
$670.06
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,037.94
|
Rate for Payer: PACE SWMI |
$988.51
|
Rate for Payer: PHP Medicare Advantage |
$988.51
|
Rate for Payer: Priority Health Choice Medicaid |
$638.15
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,226.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,412.23
|
Rate for Payer: Priority Health Medicare |
$988.51
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,412.23
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$988.51
|
Rate for Payer: UHC Dual Complete DSNP |
$988.51
|
Rate for Payer: UHC Medicare Advantage |
$1,018.17
|
|
PR VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE
|
Professional
|
Both
|
$3,659.00
|
|
Service Code
|
HCPCS 58280
|
Min. Negotiated Rate |
$237.74 |
Max. Negotiated Rate |
$2,561.30 |
Rate for Payer: Aetna Commercial |
$1,413.10
|
Rate for Payer: Aetna Medicare |
$1,096.73
|
Rate for Payer: BCBS Complete |
$714.34
|
Rate for Payer: BCBS MAPPO |
$1,054.55
|
Rate for Payer: BCBS Trust/PPO |
$237.74
|
Rate for Payer: BCN Commercial |
$1,554.97
|
Rate for Payer: BCN Medicare Advantage |
$1,054.55
|
Rate for Payer: Cash Price |
$2,927.20
|
Rate for Payer: Cash Price |
$2,927.20
|
Rate for Payer: Cofinity Commercial |
$1,518.55
|
Rate for Payer: Cofinity Commercial |
$1,413.10
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,054.55
|
Rate for Payer: Mclaren Medicaid |
$680.32
|
Rate for Payer: Meridian Medicaid |
$714.34
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,107.28
|
Rate for Payer: PACE SWMI |
$1,054.55
|
Rate for Payer: PHP Medicare Advantage |
$1,054.55
|
Rate for Payer: Priority Health Choice Medicaid |
$680.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,561.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,506.43
|
Rate for Payer: Priority Health Medicare |
$1,054.55
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,506.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,054.55
|
Rate for Payer: UHC Dual Complete DSNP |
$1,054.55
|
Rate for Payer: UHC Medicare Advantage |
$1,086.19
|
|
PR VAGINAL DELIVERY AFTER CESAREAN DELIVERY
|
Professional
|
Both
|
$2,103.00
|
|
Service Code
|
HCPCS 59612
|
Min. Negotiated Rate |
$187.55 |
Max. Negotiated Rate |
$1,636.60 |
Rate for Payer: Aetna Commercial |
$1,222.95
|
Rate for Payer: Aetna Medicare |
$949.16
|
Rate for Payer: BCBS Complete |
$885.38
|
Rate for Payer: BCBS MAPPO |
$912.65
|
Rate for Payer: BCBS Trust/PPO |
$187.55
|
Rate for Payer: BCN Commercial |
$1,636.60
|
Rate for Payer: BCN Medicare Advantage |
$912.65
|
Rate for Payer: Cash Price |
$1,682.40
|
Rate for Payer: Cash Price |
$1,682.40
|
Rate for Payer: Cofinity Commercial |
$1,314.22
|
Rate for Payer: Cofinity Commercial |
$1,222.95
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$912.65
|
Rate for Payer: Mclaren Medicaid |
$843.22
|
Rate for Payer: Meridian Medicaid |
$885.38
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$958.28
|
Rate for Payer: PACE SWMI |
$912.65
|
Rate for Payer: PHP Medicare Advantage |
$912.65
|
Rate for Payer: Priority Health Choice Medicaid |
$843.22
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,472.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,280.53
|
Rate for Payer: Priority Health Medicare |
$912.65
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,280.53
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$912.65
|
Rate for Payer: UHC Dual Complete DSNP |
$912.65
|
Rate for Payer: UHC Medicare Advantage |
$940.03
|
|
PR VAGINAL DELIVERY ONLY
|
Professional
|
Both
|
$1,931.00
|
|
Service Code
|
HCPCS 59409
|
Min. Negotiated Rate |
$45.96 |
Max. Negotiated Rate |
$1,558.66 |
Rate for Payer: Aetna Commercial |
$1,077.94
|
Rate for Payer: Aetna Medicare |
$836.61
|
Rate for Payer: BCBS Complete |
$777.93
|
Rate for Payer: BCBS MAPPO |
$804.43
|
Rate for Payer: BCBS Trust/PPO |
$45.96
|
Rate for Payer: BCN Commercial |
$1,558.66
|
Rate for Payer: BCN Medicare Advantage |
$804.43
|
Rate for Payer: Cash Price |
$1,544.80
|
Rate for Payer: Cash Price |
$1,544.80
|
Rate for Payer: Cofinity Commercial |
$1,158.38
|
Rate for Payer: Cofinity Commercial |
$1,077.94
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.43
|
Rate for Payer: Mclaren Medicaid |
$740.89
|
Rate for Payer: Meridian Medicaid |
$777.93
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$844.65
|
Rate for Payer: PACE SWMI |
$804.43
|
Rate for Payer: PHP Medicare Advantage |
$804.43
|
Rate for Payer: Priority Health Choice Medicaid |
$740.89
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,351.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,131.33
|
Rate for Payer: Priority Health Medicare |
$804.43
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,131.33
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$804.43
|
Rate for Payer: UHC Dual Complete DSNP |
$804.43
|
Rate for Payer: UHC Medicare Advantage |
$828.56
|
|