|
PR PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS
|
Professional
|
Both
|
$2,521.00
|
|
|
Service Code
|
HCPCS 50081
|
| Min. Negotiated Rate |
$638.79 |
| Max. Negotiated Rate |
$1,890.75 |
| Rate for Payer: Aetna Commercial |
$1,639.65
|
| Rate for Payer: Aetna Medicare |
$1,260.50
|
| Rate for Payer: BCBS Complete |
$670.73
|
| Rate for Payer: BCN Commercial |
$1,674.21
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Mclaren Medicaid |
$638.79
|
| Rate for Payer: Meridian Medicaid |
$670.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,890.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$638.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,823.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,823.76
|
| Rate for Payer: UHC Medicaid |
$638.79
|
| Rate for Payer: UHCCP Medicaid |
$638.79
|
|
|
PR PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION
|
Professional
|
Both
|
$1,714.00
|
|
|
Service Code
|
HCPCS 50080
|
| Min. Negotiated Rate |
$400.87 |
| Max. Negotiated Rate |
$1,285.50 |
| Rate for Payer: Aetna Commercial |
$1,115.07
|
| Rate for Payer: Aetna Medicare |
$857.00
|
| Rate for Payer: BCBS Complete |
$420.91
|
| Rate for Payer: BCN Commercial |
$1,042.27
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Mclaren Medicaid |
$400.87
|
| Rate for Payer: Meridian Medicaid |
$420.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,285.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,135.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,135.37
|
| Rate for Payer: UHC Medicaid |
$400.87
|
| Rate for Payer: UHCCP Medicaid |
$400.87
|
|
|
PR PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Professional
|
Both
|
$523.00
|
|
|
Service Code
|
HCPCS 33017
|
| Min. Negotiated Rate |
$136.53 |
| Max. Negotiated Rate |
$392.25 |
| Rate for Payer: Aetna Commercial |
$328.72
|
| Rate for Payer: Aetna Medicare |
$261.50
|
| Rate for Payer: BCBS Complete |
$143.36
|
| Rate for Payer: BCN Commercial |
$361.04
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Mclaren Medicaid |
$136.53
|
| Rate for Payer: Meridian Medicaid |
$143.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$392.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$388.25
|
| Rate for Payer: UHC Medicaid |
$136.53
|
| Rate for Payer: UHCCP Medicaid |
$136.53
|
|
|
PR PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 43762
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$333.00 |
| Rate for Payer: Aetna Commercial |
$51.19
|
| Rate for Payer: Aetna Medicare |
$222.00
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCN Commercial |
$55.77
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Mclaren Medicaid |
$21.94
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$333.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.96
|
| Rate for Payer: UHC Medicaid |
$21.94
|
| Rate for Payer: UHCCP Medicaid |
$21.94
|
|
|
PR PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC
|
Professional
|
Both
|
$662.00
|
|
|
Service Code
|
HCPCS 43763
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$496.50 |
| Rate for Payer: Aetna Commercial |
$112.71
|
| Rate for Payer: Aetna Medicare |
$331.00
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCN Commercial |
$130.97
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Mclaren Medicaid |
$53.04
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$496.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$159.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$159.57
|
| Rate for Payer: UHC Medicaid |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
|
|
PR PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS
|
Professional
|
Both
|
$2,517.00
|
|
|
Service Code
|
HCPCS 0201T
|
| Min. Negotiated Rate |
$237.73 |
| Max. Negotiated Rate |
$6,679.39 |
| Rate for Payer: Aetna Commercial |
$2,396.07
|
| Rate for Payer: Aetna Medicare |
$1,258.50
|
| Rate for Payer: BCBS Complete |
$249.62
|
| Rate for Payer: BCN Commercial |
$6,679.39
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Mclaren Medicaid |
$237.73
|
| Rate for Payer: Meridian Medicaid |
$249.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,887.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.73
|
| Rate for Payer: UHC Medicaid |
$237.73
|
| Rate for Payer: UHCCP Medicaid |
$237.73
|
|
|
PR PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL
|
Professional
|
Both
|
$2,387.00
|
|
|
Service Code
|
HCPCS 0200T
|
| Min. Negotiated Rate |
$237.73 |
| Max. Negotiated Rate |
$6,679.39 |
| Rate for Payer: Aetna Commercial |
$2,325.11
|
| Rate for Payer: Aetna Medicare |
$1,193.50
|
| Rate for Payer: BCBS Complete |
$249.62
|
| Rate for Payer: BCN Commercial |
$6,679.39
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Mclaren Medicaid |
$237.73
|
| Rate for Payer: Meridian Medicaid |
$249.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,790.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.73
|
| Rate for Payer: UHC Medicaid |
$237.73
|
| Rate for Payer: UHCCP Medicaid |
$237.73
|
|
|
PR PERQ SKELETAL FIXATION METATARSAL FX W/MNPJ EACH
|
Professional
|
Both
|
$1,109.00
|
|
|
Service Code
|
HCPCS 28476
|
| Min. Negotiated Rate |
$247.29 |
| Max. Negotiated Rate |
$831.75 |
| Rate for Payer: Aetna Commercial |
$503.59
|
| Rate for Payer: Aetna Medicare |
$554.50
|
| Rate for Payer: BCBS Complete |
$259.65
|
| Rate for Payer: BCN Commercial |
$599.57
|
| Rate for Payer: Cash Price |
$887.20
|
| Rate for Payer: Cash Price |
$887.20
|
| Rate for Payer: Mclaren Medicaid |
$247.29
|
| Rate for Payer: Meridian Medicaid |
$259.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$831.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$640.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$640.92
|
| Rate for Payer: UHC Medicaid |
$247.29
|
| Rate for Payer: UHCCP Medicaid |
$247.29
|
|
|
PR PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS
|
Professional
|
Both
|
$3,267.00
|
|
|
Service Code
|
HCPCS 27216
|
| Min. Negotiated Rate |
$508.22 |
| Max. Negotiated Rate |
$2,450.25 |
| Rate for Payer: Aetna Commercial |
$1,191.27
|
| Rate for Payer: Aetna Medicare |
$1,633.50
|
| Rate for Payer: BCBS Complete |
$533.63
|
| Rate for Payer: BCN Commercial |
$1,340.57
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Mclaren Medicaid |
$508.22
|
| Rate for Payer: Meridian Medicaid |
$533.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,433.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,433.03
|
| Rate for Payer: UHC Medicaid |
$508.22
|
| Rate for Payer: UHCCP Medicaid |
$508.22
|
|
|
PR PERQ SKELETAL FIXATION TALUS FRACTURE W/MNPJ
|
Professional
|
Both
|
$1,176.00
|
|
|
Service Code
|
HCPCS 28436
|
| Min. Negotiated Rate |
$316.94 |
| Max. Negotiated Rate |
$882.00 |
| Rate for Payer: Aetna Commercial |
$643.78
|
| Rate for Payer: Aetna Medicare |
$588.00
|
| Rate for Payer: BCBS Complete |
$332.79
|
| Rate for Payer: BCN Commercial |
$761.91
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Mclaren Medicaid |
$316.94
|
| Rate for Payer: Meridian Medicaid |
$332.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$882.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$814.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$814.46
|
| Rate for Payer: UHC Medicaid |
$316.94
|
| Rate for Payer: UHCCP Medicaid |
$316.94
|
|
|
PR PERQ SKELETAL FIXATION ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$893.00
|
|
|
Service Code
|
HCPCS 25651
|
| Min. Negotiated Rate |
$302.03 |
| Max. Negotiated Rate |
$810.74 |
| Rate for Payer: Aetna Commercial |
$650.17
|
| Rate for Payer: Aetna Medicare |
$446.50
|
| Rate for Payer: BCBS Complete |
$317.13
|
| Rate for Payer: BCN Commercial |
$758.43
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Mclaren Medicaid |
$302.03
|
| Rate for Payer: Meridian Medicaid |
$317.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$810.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$810.74
|
| Rate for Payer: UHC Medicaid |
$302.03
|
| Rate for Payer: UHCCP Medicaid |
$302.03
|
|
|
PR PERQ SKELETAL FIXJ CALCANEAL FRACTURE W/MNPJ
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 28406
|
| Min. Negotiated Rate |
$350.39 |
| Max. Negotiated Rate |
$1,213.50 |
| Rate for Payer: Aetna Commercial |
$736.35
|
| Rate for Payer: Aetna Medicare |
$809.00
|
| Rate for Payer: BCBS Complete |
$367.91
|
| Rate for Payer: BCN Commercial |
$904.83
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Mclaren Medicaid |
$350.39
|
| Rate for Payer: Meridian Medicaid |
$367.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,213.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$967.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$967.25
|
| Rate for Payer: UHC Medicaid |
$350.39
|
| Rate for Payer: UHCCP Medicaid |
$350.39
|
|
|
PR PERQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION
|
Professional
|
Both
|
$1,471.00
|
|
|
Service Code
|
HCPCS 25671
|
| Min. Negotiated Rate |
$333.35 |
| Max. Negotiated Rate |
$1,103.25 |
| Rate for Payer: Aetna Commercial |
$708.23
|
| Rate for Payer: Aetna Medicare |
$735.50
|
| Rate for Payer: BCBS Complete |
$350.02
|
| Rate for Payer: BCN Commercial |
$827.64
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Mclaren Medicaid |
$333.35
|
| Rate for Payer: Meridian Medicaid |
$350.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,103.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$884.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$884.73
|
| Rate for Payer: UHC Medicaid |
$333.35
|
| Rate for Payer: UHCCP Medicaid |
$333.35
|
|
|
PR PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP
|
Professional
|
Both
|
$2,002.00
|
|
|
Service Code
|
HCPCS 25606
|
| Min. Negotiated Rate |
$409.17 |
| Max. Negotiated Rate |
$1,501.50 |
| Rate for Payer: Aetna Commercial |
$885.42
|
| Rate for Payer: Aetna Medicare |
$1,001.00
|
| Rate for Payer: BCBS Complete |
$429.63
|
| Rate for Payer: BCN Commercial |
$1,030.32
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Mclaren Medicaid |
$409.17
|
| Rate for Payer: Meridian Medicaid |
$429.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,501.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,101.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,101.39
|
| Rate for Payer: UHC Medicaid |
$409.17
|
| Rate for Payer: UHCCP Medicaid |
$409.17
|
|
|
PR PERQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MNPJ
|
Professional
|
Both
|
$2,446.00
|
|
|
Service Code
|
HCPCS 24582
|
| Min. Negotiated Rate |
$499.27 |
| Max. Negotiated Rate |
$1,834.50 |
| Rate for Payer: Aetna Commercial |
$1,082.70
|
| Rate for Payer: Aetna Medicare |
$1,223.00
|
| Rate for Payer: BCBS Complete |
$524.23
|
| Rate for Payer: BCN Commercial |
$1,253.41
|
| Rate for Payer: Cash Price |
$1,956.80
|
| Rate for Payer: Cash Price |
$1,956.80
|
| Rate for Payer: Mclaren Medicaid |
$499.27
|
| Rate for Payer: Meridian Medicaid |
$524.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,834.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,339.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,339.87
|
| Rate for Payer: UHC Medicaid |
$499.27
|
| Rate for Payer: UHCCP Medicaid |
$499.27
|
|
|
PR PERQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MNPJ
|
Professional
|
Both
|
$1,943.00
|
|
|
Service Code
|
HCPCS 24566
|
| Min. Negotiated Rate |
$440.48 |
| Max. Negotiated Rate |
$1,457.25 |
| Rate for Payer: Aetna Commercial |
$959.55
|
| Rate for Payer: Aetna Medicare |
$971.50
|
| Rate for Payer: BCBS Complete |
$462.50
|
| Rate for Payer: BCN Commercial |
$1,108.01
|
| Rate for Payer: Cash Price |
$1,554.40
|
| Rate for Payer: Cash Price |
$1,554.40
|
| Rate for Payer: Mclaren Medicaid |
$440.48
|
| Rate for Payer: Meridian Medicaid |
$462.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,457.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,184.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,184.43
|
| Rate for Payer: UHC Medicaid |
$440.48
|
| Rate for Payer: UHCCP Medicaid |
$440.48
|
|
|
PR PERQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX
|
Professional
|
Both
|
$2,654.00
|
|
|
Service Code
|
HCPCS 24538
|
| Min. Negotiated Rate |
$479.46 |
| Max. Negotiated Rate |
$1,990.50 |
| Rate for Payer: Aetna Commercial |
$1,038.87
|
| Rate for Payer: Aetna Medicare |
$1,327.00
|
| Rate for Payer: BCBS Complete |
$503.43
|
| Rate for Payer: BCN Commercial |
$1,203.12
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Mclaren Medicaid |
$479.46
|
| Rate for Payer: Meridian Medicaid |
$503.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,990.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,286.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,286.10
|
| Rate for Payer: UHC Medicaid |
$479.46
|
| Rate for Payer: UHCCP Medicaid |
$479.46
|
|
|
PR PERQ TCAT PLMT NTRAC ST 1 LES 1+C SEGMENTS
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 92928
|
| Min. Negotiated Rate |
$295.86 |
| Max. Negotiated Rate |
$960.75 |
| Rate for Payer: Aetna Commercial |
$656.55
|
| Rate for Payer: Aetna Medicare |
$640.50
|
| Rate for Payer: BCBS Complete |
$310.65
|
| Rate for Payer: BCN Commercial |
$857.02
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Mclaren Medicaid |
$295.86
|
| Rate for Payer: Meridian Medicaid |
$310.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$814.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$814.55
|
| Rate for Payer: UHC Medicaid |
$295.86
|
| Rate for Payer: UHCCP Medicaid |
$295.86
|
|
|
PR PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS
|
Professional
|
Both
|
$1,130.00
|
|
|
Service Code
|
HCPCS 92930
|
| Min. Negotiated Rate |
$322.27 |
| Max. Negotiated Rate |
$847.50 |
| Rate for Payer: Aetna Medicare |
$565.00
|
| Rate for Payer: BCBS Complete |
$338.38
|
| Rate for Payer: Cash Price |
$904.00
|
| Rate for Payer: Cash Price |
$904.00
|
| Rate for Payer: Mclaren Medicaid |
$322.27
|
| Rate for Payer: Meridian Medicaid |
$338.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$847.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$745.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$745.13
|
| Rate for Payer: UHC Medicaid |
$322.27
|
| Rate for Payer: UHCCP Medicaid |
$322.27
|
|
|
PR PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART
|
Professional
|
Both
|
$1,179.00
|
|
|
Service Code
|
HCPCS 0913T
|
| Min. Negotiated Rate |
$471.60 |
| Max. Negotiated Rate |
$5,330.92 |
| Rate for Payer: Aetna Medicare |
$589.50
|
| Rate for Payer: BCBS Complete |
$471.60
|
| Rate for Payer: BCN Commercial |
$5,330.92
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$884.25
|
|
|
PR PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 0914T
|
| Min. Negotiated Rate |
$236.00 |
| Max. Negotiated Rate |
$442.50 |
| Rate for Payer: Aetna Medicare |
$295.00
|
| Rate for Payer: BCBS Complete |
$236.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.50
|
|
|
PR PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT
|
Professional
|
Both
|
$1,588.00
|
|
|
Service Code
|
HCPCS 36906
|
| Min. Negotiated Rate |
$283.93 |
| Max. Negotiated Rate |
$1,191.00 |
| Rate for Payer: Aetna Commercial |
$685.46
|
| Rate for Payer: Aetna Medicare |
$794.00
|
| Rate for Payer: BCBS Complete |
$298.13
|
| Rate for Payer: BCN Commercial |
$742.49
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Mclaren Medicaid |
$283.93
|
| Rate for Payer: Meridian Medicaid |
$298.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$798.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$798.46
|
| Rate for Payer: UHC Medicaid |
$283.93
|
| Rate for Payer: UHCCP Medicaid |
$283.93
|
|
|
PR PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP
|
Professional
|
Both
|
$1,362.00
|
|
|
Service Code
|
HCPCS 36905
|
| Min. Negotiated Rate |
$246.02 |
| Max. Negotiated Rate |
$1,021.50 |
| Rate for Payer: Aetna Commercial |
$594.60
|
| Rate for Payer: Aetna Medicare |
$681.00
|
| Rate for Payer: BCBS Complete |
$258.32
|
| Rate for Payer: BCN Commercial |
$644.89
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Mclaren Medicaid |
$246.02
|
| Rate for Payer: Meridian Medicaid |
$258.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,021.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$693.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$693.50
|
| Rate for Payer: UHC Medicaid |
$246.02
|
| Rate for Payer: UHCCP Medicaid |
$246.02
|
|
|
PR PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 36904
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$685.50 |
| Rate for Payer: Aetna Commercial |
$493.49
|
| Rate for Payer: Aetna Medicare |
$457.00
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCN Commercial |
$535.83
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Mclaren Medicaid |
$204.48
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$685.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$576.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$576.22
|
| Rate for Payer: UHC Medicaid |
$204.48
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 33897
|
| Min. Negotiated Rate |
$319.93 |
| Max. Negotiated Rate |
$960.75 |
| Rate for Payer: Aetna Commercial |
$769.84
|
| Rate for Payer: Aetna Medicare |
$640.50
|
| Rate for Payer: BCBS Complete |
$335.93
|
| Rate for Payer: BCN Commercial |
$846.57
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Mclaren Medicaid |
$319.93
|
| Rate for Payer: Meridian Medicaid |
$335.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$910.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$910.38
|
| Rate for Payer: UHC Medicaid |
$319.93
|
| Rate for Payer: UHCCP Medicaid |
$319.93
|
|
