|
PR PARTIAL EXCISION BONE FIBULA
|
Professional
|
Both
|
$2,457.00
|
|
|
Service Code
|
HCPCS 27641
|
| Min. Negotiated Rate |
$388.94 |
| Max. Negotiated Rate |
$1,842.75 |
| Rate for Payer: Aetna Commercial |
$876.29
|
| Rate for Payer: Aetna Medicare |
$1,228.50
|
| Rate for Payer: BCBS Complete |
$408.39
|
| Rate for Payer: BCN Commercial |
$997.95
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Mclaren Medicaid |
$388.94
|
| Rate for Payer: Meridian Medicaid |
$408.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,842.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,066.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,066.78
|
| Rate for Payer: UHC Medicaid |
$388.94
|
| Rate for Payer: UHCCP Medicaid |
$388.94
|
|
|
PR PARTIAL EXCISION BONE HUMERUS
|
Professional
|
Both
|
$1,472.00
|
|
|
Service Code
|
HCPCS 24140
|
| Min. Negotiated Rate |
$418.33 |
| Max. Negotiated Rate |
$1,150.36 |
| Rate for Payer: Aetna Commercial |
$938.53
|
| Rate for Payer: Aetna Medicare |
$736.00
|
| Rate for Payer: BCBS Complete |
$439.25
|
| Rate for Payer: BCN Commercial |
$1,076.14
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Mclaren Medicaid |
$418.33
|
| Rate for Payer: Meridian Medicaid |
$439.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,104.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,150.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.36
|
| Rate for Payer: UHC Medicaid |
$418.33
|
| Rate for Payer: UHCCP Medicaid |
$418.33
|
|
|
PR PARTIAL EXCISION BONE METACARPAL
|
Professional
|
Both
|
$1,498.00
|
|
|
Service Code
|
HCPCS 26230
|
| Min. Negotiated Rate |
$300.76 |
| Max. Negotiated Rate |
$1,123.50 |
| Rate for Payer: Aetna Commercial |
$666.02
|
| Rate for Payer: Aetna Medicare |
$749.00
|
| Rate for Payer: BCBS Complete |
$315.80
|
| Rate for Payer: BCN Commercial |
$770.87
|
| Rate for Payer: Cash Price |
$1,198.40
|
| Rate for Payer: Cash Price |
$1,198.40
|
| Rate for Payer: Mclaren Medicaid |
$300.76
|
| Rate for Payer: Meridian Medicaid |
$315.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,123.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$824.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$824.04
|
| Rate for Payer: UHC Medicaid |
$300.76
|
| Rate for Payer: UHCCP Medicaid |
$300.76
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 24147
|
| Min. Negotiated Rate |
$380.42 |
| Max. Negotiated Rate |
$1,144.50 |
| Rate for Payer: Aetna Commercial |
$836.32
|
| Rate for Payer: Aetna Medicare |
$763.00
|
| Rate for Payer: BCBS Complete |
$399.44
|
| Rate for Payer: BCN Commercial |
$965.58
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Mclaren Medicaid |
$380.42
|
| Rate for Payer: Meridian Medicaid |
$399.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,144.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,032.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,032.19
|
| Rate for Payer: UHC Medicaid |
$380.42
|
| Rate for Payer: UHCCP Medicaid |
$380.42
|
|
|
PR PARTIAL EXCISION BONE PROXIMAL HUMERUS
|
Professional
|
Both
|
$1,714.00
|
|
|
Service Code
|
HCPCS 23184
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$1,285.50 |
| Rate for Payer: Aetna Commercial |
$986.17
|
| Rate for Payer: Aetna Medicare |
$857.00
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCN Commercial |
$1,130.42
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Mclaren Medicaid |
$444.11
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,285.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,208.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,208.39
|
| Rate for Payer: UHC Medicaid |
$444.11
|
| Rate for Payer: UHCCP Medicaid |
$444.11
|
|
|
PR PARTIAL EXCISION BONE RADIUS
|
Professional
|
Both
|
$2,358.00
|
|
|
Service Code
|
HCPCS 25151
|
| Min. Negotiated Rate |
$348.04 |
| Max. Negotiated Rate |
$1,768.50 |
| Rate for Payer: Aetna Commercial |
$780.47
|
| Rate for Payer: Aetna Medicare |
$1,179.00
|
| Rate for Payer: BCBS Complete |
$365.44
|
| Rate for Payer: BCN Commercial |
$899.36
|
| Rate for Payer: Cash Price |
$1,886.40
|
| Rate for Payer: Cash Price |
$1,886.40
|
| Rate for Payer: Mclaren Medicaid |
$348.04
|
| Rate for Payer: Meridian Medicaid |
$365.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,768.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$961.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$961.39
|
| Rate for Payer: UHC Medicaid |
$348.04
|
| Rate for Payer: UHCCP Medicaid |
$348.04
|
|
|
PR PARTIAL EXCISION BONE SCAPULA
|
Professional
|
Both
|
$1,303.00
|
|
|
Service Code
|
HCPCS 23182
|
| Min. Negotiated Rate |
$408.75 |
| Max. Negotiated Rate |
$1,102.46 |
| Rate for Payer: Aetna Commercial |
$893.47
|
| Rate for Payer: Aetna Medicare |
$651.50
|
| Rate for Payer: BCBS Complete |
$429.19
|
| Rate for Payer: BCN Commercial |
$1,031.31
|
| Rate for Payer: Cash Price |
$1,042.40
|
| Rate for Payer: Cash Price |
$1,042.40
|
| Rate for Payer: Mclaren Medicaid |
$408.75
|
| Rate for Payer: Meridian Medicaid |
$429.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$977.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,102.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,102.46
|
| Rate for Payer: UHC Medicaid |
$408.75
|
| Rate for Payer: UHCCP Medicaid |
$408.75
|
|
|
PR PARTIAL EXCISION BONE TALUS/CALCANEUS
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 28120
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna Commercial |
$658.97
|
| Rate for Payer: Aetna Medicare |
$656.00
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCN Commercial |
$751.96
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Mclaren Medicaid |
$298.84
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$803.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$803.81
|
| Rate for Payer: UHC Medicaid |
$298.84
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
|
|
PR PARTIAL EXCISION BONE TIBIA
|
Professional
|
Both
|
$2,846.00
|
|
|
Service Code
|
HCPCS 27640
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,134.50 |
| Rate for Payer: Aetna Commercial |
$1,110.44
|
| Rate for Payer: Aetna Medicare |
$1,423.00
|
| Rate for Payer: BCBS Complete |
$514.62
|
| Rate for Payer: BCN Commercial |
$1,255.41
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Meridian Medicaid |
$514.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,134.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,342.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,342.01
|
| Rate for Payer: UHC Medicaid |
$490.11
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
|
|
PR PARTIAL EXCISION BONE ULNA
|
Professional
|
Both
|
$1,214.00
|
|
|
Service Code
|
HCPCS 25150
|
| Min. Negotiated Rate |
$341.01 |
| Max. Negotiated Rate |
$934.23 |
| Rate for Payer: Aetna Commercial |
$756.27
|
| Rate for Payer: Aetna Medicare |
$607.00
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCN Commercial |
$873.95
|
| Rate for Payer: Cash Price |
$971.20
|
| Rate for Payer: Cash Price |
$971.20
|
| Rate for Payer: Mclaren Medicaid |
$341.01
|
| Rate for Payer: Meridian Medicaid |
$358.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$910.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$934.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$934.23
|
| Rate for Payer: UHC Medicaid |
$341.01
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
|
|
PR PARTIAL EXCISION DEEP PELVIS
|
Professional
|
Both
|
$3,324.00
|
|
|
Service Code
|
HCPCS 27071
|
| Min. Negotiated Rate |
$584.26 |
| Max. Negotiated Rate |
$2,493.00 |
| Rate for Payer: Aetna Commercial |
$1,287.18
|
| Rate for Payer: Aetna Medicare |
$1,662.00
|
| Rate for Payer: BCBS Complete |
$613.47
|
| Rate for Payer: BCN Commercial |
$1,464.06
|
| Rate for Payer: Cash Price |
$2,659.20
|
| Rate for Payer: Cash Price |
$2,659.20
|
| Rate for Payer: Mclaren Medicaid |
$584.26
|
| Rate for Payer: Meridian Medicaid |
$613.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,493.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$584.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,565.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.05
|
| Rate for Payer: UHC Medicaid |
$584.26
|
| Rate for Payer: UHCCP Medicaid |
$584.26
|
|
|
PR PARTIAL EXCISION DISTAL PHALANX FINGER
|
Professional
|
Both
|
$1,310.00
|
|
|
Service Code
|
HCPCS 26236
|
| Min. Negotiated Rate |
$269.23 |
| Max. Negotiated Rate |
$982.50 |
| Rate for Payer: Aetna Commercial |
$586.97
|
| Rate for Payer: Aetna Medicare |
$655.00
|
| Rate for Payer: BCBS Complete |
$282.69
|
| Rate for Payer: BCN Commercial |
$682.73
|
| Rate for Payer: Cash Price |
$1,048.00
|
| Rate for Payer: Cash Price |
$1,048.00
|
| Rate for Payer: Mclaren Medicaid |
$269.23
|
| Rate for Payer: Meridian Medicaid |
$282.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$982.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$729.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$729.82
|
| Rate for Payer: UHC Medicaid |
$269.23
|
| Rate for Payer: UHCCP Medicaid |
$269.23
|
|
|
PR PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,404.00
|
|
|
Service Code
|
HCPCS 26235
|
| Min. Negotiated Rate |
$296.28 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Aetna Commercial |
$655.87
|
| Rate for Payer: Aetna Medicare |
$702.00
|
| Rate for Payer: BCBS Complete |
$311.09
|
| Rate for Payer: BCN Commercial |
$759.43
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Mclaren Medicaid |
$296.28
|
| Rate for Payer: Meridian Medicaid |
$311.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$811.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$811.79
|
| Rate for Payer: UHC Medicaid |
$296.28
|
| Rate for Payer: UHCCP Medicaid |
$296.28
|
|
|
PR PARTIAL EXCISION SUPERFICIAL PELVIS
|
Professional
|
Both
|
$1,574.00
|
|
|
Service Code
|
HCPCS 27070
|
| Min. Negotiated Rate |
$526.75 |
| Max. Negotiated Rate |
$1,417.59 |
| Rate for Payer: Aetna Commercial |
$1,180.76
|
| Rate for Payer: Aetna Medicare |
$787.00
|
| Rate for Payer: BCBS Complete |
$553.09
|
| Rate for Payer: BCN Commercial |
$1,326.12
|
| Rate for Payer: Cash Price |
$1,259.20
|
| Rate for Payer: Cash Price |
$1,259.20
|
| Rate for Payer: Mclaren Medicaid |
$526.75
|
| Rate for Payer: Meridian Medicaid |
$553.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,180.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,417.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,417.59
|
| Rate for Payer: UHC Medicaid |
$526.75
|
| Rate for Payer: UHCCP Medicaid |
$526.75
|
|
|
PR PARTIAL HYMENECTOMY OR REVISION HYMENAL RING
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 56700
|
| Min. Negotiated Rate |
$115.87 |
| Max. Negotiated Rate |
$507.75 |
| Rate for Payer: Aetna Commercial |
$238.45
|
| Rate for Payer: Aetna Medicare |
$338.50
|
| Rate for Payer: BCBS Complete |
$121.66
|
| Rate for Payer: BCN Commercial |
$305.76
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Mclaren Medicaid |
$115.87
|
| Rate for Payer: Meridian Medicaid |
$121.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$309.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$309.67
|
| Rate for Payer: UHC Medicaid |
$115.87
|
| Rate for Payer: UHCCP Medicaid |
$115.87
|
|
|
PR PARTICAL EXCISION BONE PHALANX TOE
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 28124
|
| Min. Negotiated Rate |
$202.78 |
| Max. Negotiated Rate |
$705.75 |
| Rate for Payer: Aetna Commercial |
$438.66
|
| Rate for Payer: Aetna Medicare |
$470.50
|
| Rate for Payer: BCBS Complete |
$212.92
|
| Rate for Payer: BCN Commercial |
$510.93
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Mclaren Medicaid |
$202.78
|
| Rate for Payer: Meridian Medicaid |
$212.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$546.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$546.18
|
| Rate for Payer: UHC Medicaid |
$202.78
|
| Rate for Payer: UHCCP Medicaid |
$202.78
|
|
|
PR PATELLECTOMY/HEMIPATELLECTOMY
|
Professional
|
Both
|
$2,164.00
|
|
|
Service Code
|
HCPCS 27350
|
| Min. Negotiated Rate |
$395.54 |
| Max. Negotiated Rate |
$1,623.00 |
| Rate for Payer: Aetna Commercial |
$871.76
|
| Rate for Payer: Aetna Medicare |
$1,082.00
|
| Rate for Payer: BCBS Complete |
$415.32
|
| Rate for Payer: BCN Commercial |
$1,002.43
|
| Rate for Payer: Cash Price |
$1,731.20
|
| Rate for Payer: Cash Price |
$1,731.20
|
| Rate for Payer: Mclaren Medicaid |
$395.54
|
| Rate for Payer: Meridian Medicaid |
$415.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,071.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,071.58
|
| Rate for Payer: UHC Medicaid |
$395.54
|
| Rate for Payer: UHCCP Medicaid |
$395.54
|
|
|
PR PATIENT-INITIATED SPIROMETRIC RECORDING
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 94015
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$47.81 |
| Rate for Payer: Aetna Commercial |
$32.07
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCN Commercial |
$47.81
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.08
|
|
|
PR PCV13 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 90670
|
| Min. Negotiated Rate |
$149.50 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$257.99
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: BCBS Trust/PPO |
$226.43
|
| Rate for Payer: BCN Commercial |
$270.00
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$224.25
|
|
|
PR PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 90677
|
| Min. Negotiated Rate |
$203.50 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna Commercial |
$288.66
|
| Rate for Payer: Aetna Medicare |
$203.50
|
| Rate for Payer: BCBS Trust/PPO |
$299.25
|
| Rate for Payer: BCN Commercial |
$350.00
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$305.25
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 96573
|
| Min. Negotiated Rate |
$188.00 |
| Max. Negotiated Rate |
$327.67 |
| Rate for Payer: Aetna Commercial |
$247.38
|
| Rate for Payer: Aetna Medicare |
$188.00
|
| Rate for Payer: BCN Commercial |
$327.67
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$302.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$302.18
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 96567
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$196.71 |
| Rate for Payer: Aetna Commercial |
$151.34
|
| Rate for Payer: Aetna Medicare |
$112.50
|
| Rate for Payer: BCBS Complete |
$90.00
|
| Rate for Payer: BCN Commercial |
$196.71
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.40
|
|
|
PR PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR
|
Professional
|
Both
|
$1,337.00
|
|
|
Service Code
|
HCPCS 38770
|
| Min. Negotiated Rate |
$471.37 |
| Max. Negotiated Rate |
$1,606.81 |
| Rate for Payer: Aetna Commercial |
$995.43
|
| Rate for Payer: Aetna Medicare |
$668.50
|
| Rate for Payer: BCBS Complete |
$494.94
|
| Rate for Payer: BCN Commercial |
$1,207.61
|
| Rate for Payer: Cash Price |
$1,069.60
|
| Rate for Payer: Cash Price |
$1,069.60
|
| Rate for Payer: Mclaren Medicaid |
$471.37
|
| Rate for Payer: Meridian Medicaid |
$494.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,606.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,606.81
|
| Rate for Payer: UHC Medicaid |
$471.37
|
| Rate for Payer: UHCCP Medicaid |
$471.37
|
|
|
PR PELVIC EXAMINATION
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 99459
|
| Min. Negotiated Rate |
$20.49 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Commercial |
$20.49
|
| Rate for Payer: Aetna Medicare |
$24.50
|
| Rate for Payer: BCN Commercial |
$31.87
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.67
|
|
|
PR PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 57410
|
| Min. Negotiated Rate |
$61.56 |
| Max. Negotiated Rate |
$160.89 |
| Rate for Payer: Aetna Commercial |
$125.13
|
| Rate for Payer: Aetna Medicare |
$101.00
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCN Commercial |
$158.86
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Mclaren Medicaid |
$61.56
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$160.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.89
|
| Rate for Payer: UHC Medicaid |
$61.56
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
|
