|
PR REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH
|
Professional
|
Both
|
$4,445.00
|
|
|
Service Code
|
HCPCS 33362
|
| Min. Negotiated Rate |
$749.55 |
| Max. Negotiated Rate |
$3,333.75 |
| Rate for Payer: Aetna Commercial |
$1,772.76
|
| Rate for Payer: Aetna Medicare |
$2,222.50
|
| Rate for Payer: BCBS Complete |
$787.03
|
| Rate for Payer: BCN Commercial |
$1,929.68
|
| Rate for Payer: Cash Price |
$3,556.00
|
| Rate for Payer: Cash Price |
$3,556.00
|
| Rate for Payer: Mclaren Medicaid |
$749.55
|
| Rate for Payer: Meridian Medicaid |
$787.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,333.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,075.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,075.13
|
| Rate for Payer: UHC Medicaid |
$749.55
|
| Rate for Payer: UHCCP Medicaid |
$749.55
|
|
|
PR REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH
|
Professional
|
Both
|
$5,371.00
|
|
|
Service Code
|
HCPCS 33365
|
| Min. Negotiated Rate |
$812.60 |
| Max. Negotiated Rate |
$4,028.25 |
| Rate for Payer: Aetna Commercial |
$1,916.59
|
| Rate for Payer: Aetna Medicare |
$2,685.50
|
| Rate for Payer: BCBS Complete |
$853.23
|
| Rate for Payer: BCN Commercial |
$2,081.56
|
| Rate for Payer: Cash Price |
$4,296.80
|
| Rate for Payer: Cash Price |
$4,296.80
|
| Rate for Payer: Mclaren Medicaid |
$812.60
|
| Rate for Payer: Meridian Medicaid |
$853.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,028.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,238.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,238.45
|
| Rate for Payer: UHC Medicaid |
$812.60
|
| Rate for Payer: UHCCP Medicaid |
$812.60
|
|
|
PR REPLACE AORTIC VALVE OPEN TRANSTHORACIC APPROACH
|
Professional
|
Both
|
$3,266.00
|
|
|
Service Code
|
HCPCS 0318T
|
| Min. Negotiated Rate |
$1,306.40 |
| Max. Negotiated Rate |
$2,449.50 |
| Rate for Payer: Aetna Medicare |
$1,633.00
|
| Rate for Payer: BCBS Complete |
$1,306.40
|
| Rate for Payer: Cash Price |
$2,612.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,449.50
|
|
|
PR REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH
|
Professional
|
Both
|
$4,063.00
|
|
|
Service Code
|
HCPCS 33361
|
| Min. Negotiated Rate |
$688.20 |
| Max. Negotiated Rate |
$3,047.25 |
| Rate for Payer: Aetna Commercial |
$1,626.97
|
| Rate for Payer: Aetna Medicare |
$2,031.50
|
| Rate for Payer: BCBS Complete |
$722.61
|
| Rate for Payer: BCN Commercial |
$1,768.33
|
| Rate for Payer: Cash Price |
$3,250.40
|
| Rate for Payer: Cash Price |
$3,250.40
|
| Rate for Payer: Mclaren Medicaid |
$688.20
|
| Rate for Payer: Meridian Medicaid |
$722.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,047.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$688.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,901.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,901.61
|
| Rate for Payer: UHC Medicaid |
$688.20
|
| Rate for Payer: UHCCP Medicaid |
$688.20
|
|
|
PR REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 33368
|
| Min. Negotiated Rate |
$431.54 |
| Max. Negotiated Rate |
$1,715.25 |
| Rate for Payer: Aetna Commercial |
$1,000.30
|
| Rate for Payer: Aetna Medicare |
$1,143.50
|
| Rate for Payer: BCBS Complete |
$453.12
|
| Rate for Payer: BCN Commercial |
$1,077.13
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Mclaren Medicaid |
$431.54
|
| Rate for Payer: Meridian Medicaid |
$453.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,715.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,158.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,158.31
|
| Rate for Payer: UHC Medicaid |
$431.54
|
| Rate for Payer: UHCCP Medicaid |
$431.54
|
|
|
PR REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 49451
|
| Min. Negotiated Rate |
$48.56 |
| Max. Negotiated Rate |
$1,054.50 |
| Rate for Payer: Aetna Commercial |
$118.55
|
| Rate for Payer: Aetna Medicare |
$703.00
|
| Rate for Payer: BCBS Complete |
$50.99
|
| Rate for Payer: BCN Commercial |
$129.48
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Mclaren Medicaid |
$48.56
|
| Rate for Payer: Meridian Medicaid |
$50.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,054.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$157.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.76
|
| Rate for Payer: UHC Medicaid |
$48.56
|
| Rate for Payer: UHCCP Medicaid |
$48.56
|
|
|
PR REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,245.00
|
|
|
Service Code
|
HCPCS 49450
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$933.75 |
| Rate for Payer: Aetna Commercial |
$88.08
|
| Rate for Payer: Aetna Medicare |
$622.50
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCN Commercial |
$96.60
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Mclaren Medicaid |
$36.00
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$933.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.71
|
| Rate for Payer: UHC Medicaid |
$36.00
|
| Rate for Payer: UHCCP Medicaid |
$36.00
|
|
|
PR REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,538.00
|
|
|
Service Code
|
HCPCS 49452
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$1,153.50 |
| Rate for Payer: Aetna Commercial |
$183.16
|
| Rate for Payer: Aetna Medicare |
$769.00
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCN Commercial |
$199.19
|
| Rate for Payer: Cash Price |
$1,230.40
|
| Rate for Payer: Cash Price |
$1,230.40
|
| Rate for Payer: Mclaren Medicaid |
$74.55
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,153.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$242.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.71
|
| Rate for Payer: UHC Medicaid |
$74.55
|
| Rate for Payer: UHCCP Medicaid |
$74.55
|
|
|
PR REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP
|
Professional
|
Both
|
$6,040.00
|
|
|
Service Code
|
HCPCS 33430
|
| Min. Negotiated Rate |
$1,672.69 |
| Max. Negotiated Rate |
$4,530.00 |
| Rate for Payer: Aetna Commercial |
$3,761.38
|
| Rate for Payer: Aetna Medicare |
$3,020.00
|
| Rate for Payer: BCBS Complete |
$1,756.32
|
| Rate for Payer: BCN Commercial |
$4,116.31
|
| Rate for Payer: Cash Price |
$4,832.00
|
| Rate for Payer: Cash Price |
$4,832.00
|
| Rate for Payer: Mclaren Medicaid |
$1,672.69
|
| Rate for Payer: Meridian Medicaid |
$1,756.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,530.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,672.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,426.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,426.57
|
| Rate for Payer: UHC Medicaid |
$1,672.69
|
| Rate for Payer: UHCCP Medicaid |
$1,672.69
|
|
|
PR REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 11970
|
| Min. Negotiated Rate |
$329.94 |
| Max. Negotiated Rate |
$852.75 |
| Rate for Payer: Aetna Commercial |
$605.68
|
| Rate for Payer: Aetna Medicare |
$568.50
|
| Rate for Payer: BCBS Complete |
$346.44
|
| Rate for Payer: BCN Commercial |
$852.54
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Mclaren Medicaid |
$329.94
|
| Rate for Payer: Meridian Medicaid |
$346.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$780.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$780.29
|
| Rate for Payer: UHC Medicaid |
$329.94
|
| Rate for Payer: UHCCP Medicaid |
$329.94
|
|
|
PR REPLACEMENT TRICUSPID VALVE W/CARD BYPASS
|
Professional
|
Both
|
$9,074.00
|
|
|
Service Code
|
HCPCS 33465
|
| Min. Negotiated Rate |
$1,634.99 |
| Max. Negotiated Rate |
$6,805.50 |
| Rate for Payer: Aetna Commercial |
$3,697.17
|
| Rate for Payer: Aetna Medicare |
$4,537.00
|
| Rate for Payer: BCBS Complete |
$1,716.74
|
| Rate for Payer: BCN Commercial |
$4,039.62
|
| Rate for Payer: Cash Price |
$7,259.20
|
| Rate for Payer: Cash Price |
$7,259.20
|
| Rate for Payer: Mclaren Medicaid |
$1,634.99
|
| Rate for Payer: Meridian Medicaid |
$1,716.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,805.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,634.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,344.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,344.11
|
| Rate for Payer: UHC Medicaid |
$1,634.99
|
| Rate for Payer: UHCCP Medicaid |
$1,634.99
|
|
|
PR REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ
|
Professional
|
Both
|
$509.00
|
|
|
Service Code
|
HCPCS 33993
|
| Min. Negotiated Rate |
$90.74 |
| Max. Negotiated Rate |
$381.75 |
| Rate for Payer: Aetna Commercial |
$222.32
|
| Rate for Payer: Aetna Medicare |
$254.50
|
| Rate for Payer: BCBS Complete |
$95.28
|
| Rate for Payer: BCN Commercial |
$242.02
|
| Rate for Payer: Cash Price |
$407.20
|
| Rate for Payer: Cash Price |
$407.20
|
| Rate for Payer: Mclaren Medicaid |
$90.74
|
| Rate for Payer: Meridian Medicaid |
$95.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$260.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.25
|
| Rate for Payer: UHC Medicaid |
$90.74
|
| Rate for Payer: UHCCP Medicaid |
$90.74
|
|
|
PR REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO
|
Professional
|
Both
|
$387.00
|
|
|
Service Code
|
HCPCS 43761
|
| Min. Negotiated Rate |
$56.45 |
| Max. Negotiated Rate |
$290.25 |
| Rate for Payer: Aetna Commercial |
$139.84
|
| Rate for Payer: Aetna Medicare |
$193.50
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCN Commercial |
$153.38
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Mclaren Medicaid |
$56.45
|
| Rate for Payer: Meridian Medicaid |
$59.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$186.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.89
|
| Rate for Payer: UHC Medicaid |
$56.45
|
| Rate for Payer: UHCCP Medicaid |
$56.45
|
|
|
PR REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 33273
|
| Min. Negotiated Rate |
$228.98 |
| Max. Negotiated Rate |
$650.25 |
| Rate for Payer: Aetna Commercial |
$534.44
|
| Rate for Payer: Aetna Medicare |
$433.50
|
| Rate for Payer: BCBS Complete |
$240.43
|
| Rate for Payer: BCN Commercial |
$592.59
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Mclaren Medicaid |
$228.98
|
| Rate for Payer: Meridian Medicaid |
$240.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$650.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$637.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$637.26
|
| Rate for Payer: UHC Medicaid |
$228.98
|
| Rate for Payer: UHCCP Medicaid |
$228.98
|
|
|
PR REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 62252
|
| Min. Negotiated Rate |
$103.38 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Commercial |
$103.38
|
| Rate for Payer: Aetna Medicare |
$157.50
|
| Rate for Payer: BCN Commercial |
$182.32
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$153.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$153.28
|
|
|
PR RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ
|
Professional
|
Both
|
$5,079.00
|
|
|
Service Code
|
HCPCS 32504
|
| Min. Negotiated Rate |
$1,224.11 |
| Max. Negotiated Rate |
$3,809.25 |
| Rate for Payer: Aetna Commercial |
$2,643.29
|
| Rate for Payer: Aetna Medicare |
$2,539.50
|
| Rate for Payer: BCBS Complete |
$1,285.32
|
| Rate for Payer: BCN Commercial |
$3,012.29
|
| Rate for Payer: Cash Price |
$4,063.20
|
| Rate for Payer: Cash Price |
$4,063.20
|
| Rate for Payer: Mclaren Medicaid |
$1,224.11
|
| Rate for Payer: Meridian Medicaid |
$1,285.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,809.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,224.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,836.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,836.68
|
| Rate for Payer: UHC Medicaid |
$1,224.11
|
| Rate for Payer: UHCCP Medicaid |
$1,224.11
|
|
|
PR RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ
|
Professional
|
Both
|
$3,780.00
|
|
|
Service Code
|
HCPCS 32503
|
| Min. Negotiated Rate |
$1,079.70 |
| Max. Negotiated Rate |
$2,835.00 |
| Rate for Payer: Aetna Commercial |
$2,319.27
|
| Rate for Payer: Aetna Medicare |
$1,890.00
|
| Rate for Payer: BCBS Complete |
$1,133.68
|
| Rate for Payer: BCN Commercial |
$2,647.76
|
| Rate for Payer: Cash Price |
$3,024.00
|
| Rate for Payer: Cash Price |
$3,024.00
|
| Rate for Payer: Mclaren Medicaid |
$1,079.70
|
| Rate for Payer: Meridian Medicaid |
$1,133.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,835.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,079.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,493.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,493.40
|
| Rate for Payer: UHC Medicaid |
$1,079.70
|
| Rate for Payer: UHCCP Medicaid |
$1,079.70
|
|
|
PR RESCJ DIAPHRAGM W/COMPLEX REPAIR
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 39561
|
| Min. Negotiated Rate |
$776.60 |
| Max. Negotiated Rate |
$2,025.86 |
| Rate for Payer: Aetna Commercial |
$1,273.41
|
| Rate for Payer: Aetna Medicare |
$1,164.50
|
| Rate for Payer: BCBS Complete |
$815.43
|
| Rate for Payer: BCN Commercial |
$1,883.87
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Mclaren Medicaid |
$776.60
|
| Rate for Payer: Meridian Medicaid |
$815.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,746.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$776.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,025.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,025.86
|
| Rate for Payer: UHC Medicaid |
$776.60
|
| Rate for Payer: UHCCP Medicaid |
$776.60
|
|
|
PR RESCJ DIAPHRAGM W/SIMPLE REPAIR
|
Professional
|
Both
|
$3,786.00
|
|
|
Service Code
|
HCPCS 39560
|
| Min. Negotiated Rate |
$483.94 |
| Max. Negotiated Rate |
$2,839.50 |
| Rate for Payer: Aetna Commercial |
$818.99
|
| Rate for Payer: Aetna Medicare |
$1,893.00
|
| Rate for Payer: BCBS Complete |
$508.14
|
| Rate for Payer: BCN Commercial |
$1,205.61
|
| Rate for Payer: Cash Price |
$3,028.80
|
| Rate for Payer: Cash Price |
$3,028.80
|
| Rate for Payer: Mclaren Medicaid |
$483.94
|
| Rate for Payer: Meridian Medicaid |
$508.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,839.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,296.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,296.49
|
| Rate for Payer: UHC Medicaid |
$483.94
|
| Rate for Payer: UHCCP Medicaid |
$483.94
|
|
|
PR RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL
|
Professional
|
Both
|
$5,580.00
|
|
|
Service Code
|
HCPCS 61600
|
| Min. Negotiated Rate |
$1,221.13 |
| Max. Negotiated Rate |
$4,185.00 |
| Rate for Payer: Aetna Commercial |
$2,761.75
|
| Rate for Payer: Aetna Medicare |
$2,790.00
|
| Rate for Payer: BCBS Complete |
$1,282.19
|
| Rate for Payer: BCN Commercial |
$3,166.66
|
| Rate for Payer: Cash Price |
$4,464.00
|
| Rate for Payer: Cash Price |
$4,464.00
|
| Rate for Payer: Mclaren Medicaid |
$1,221.13
|
| Rate for Payer: Meridian Medicaid |
$1,282.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,185.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,221.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,678.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,678.01
|
| Rate for Payer: UHC Medicaid |
$1,221.13
|
| Rate for Payer: UHCCP Medicaid |
$1,221.13
|
|
|
PR RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF
|
Professional
|
Both
|
$7,688.00
|
|
|
Service Code
|
HCPCS 61601
|
| Min. Negotiated Rate |
$1,530.83 |
| Max. Negotiated Rate |
$5,766.00 |
| Rate for Payer: Aetna Commercial |
$3,136.72
|
| Rate for Payer: Aetna Medicare |
$3,844.00
|
| Rate for Payer: BCBS Complete |
$1,607.37
|
| Rate for Payer: BCN Commercial |
$5,040.09
|
| Rate for Payer: Cash Price |
$6,150.40
|
| Rate for Payer: Cash Price |
$6,150.40
|
| Rate for Payer: Mclaren Medicaid |
$1,530.83
|
| Rate for Payer: Meridian Medicaid |
$1,607.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,766.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,530.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,237.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,237.32
|
| Rate for Payer: UHC Medicaid |
$1,530.83
|
| Rate for Payer: UHCCP Medicaid |
$1,530.83
|
|
|
PR RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL
|
Professional
|
Both
|
$7,183.00
|
|
|
Service Code
|
HCPCS 61616
|
| Min. Negotiated Rate |
$2,012.21 |
| Max. Negotiated Rate |
$6,919.64 |
| Rate for Payer: Aetna Commercial |
$4,330.86
|
| Rate for Payer: Aetna Medicare |
$3,591.50
|
| Rate for Payer: BCBS Complete |
$2,112.82
|
| Rate for Payer: BCN Commercial |
$6,919.64
|
| Rate for Payer: Cash Price |
$5,746.40
|
| Rate for Payer: Cash Price |
$5,746.40
|
| Rate for Payer: Mclaren Medicaid |
$2,012.21
|
| Rate for Payer: Meridian Medicaid |
$2,112.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,387.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,012.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,817.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,817.50
|
| Rate for Payer: UHC Medicaid |
$2,012.21
|
| Rate for Payer: UHCCP Medicaid |
$2,012.21
|
|
|
PR RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL
|
Professional
|
Both
|
$7,442.00
|
|
|
Service Code
|
HCPCS 61615
|
| Min. Negotiated Rate |
$1,797.29 |
| Max. Negotiated Rate |
$5,581.50 |
| Rate for Payer: Aetna Commercial |
$3,660.27
|
| Rate for Payer: Aetna Medicare |
$3,721.00
|
| Rate for Payer: BCBS Complete |
$1,887.15
|
| Rate for Payer: BCN Commercial |
$4,248.77
|
| Rate for Payer: Cash Price |
$5,953.60
|
| Rate for Payer: Cash Price |
$5,953.60
|
| Rate for Payer: Mclaren Medicaid |
$1,797.29
|
| Rate for Payer: Meridian Medicaid |
$1,887.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,581.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,797.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,934.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,934.86
|
| Rate for Payer: UHC Medicaid |
$1,797.29
|
| Rate for Payer: UHCCP Medicaid |
$1,797.29
|
|
|
PR RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL
|
Professional
|
Both
|
$4,866.00
|
|
|
Service Code
|
HCPCS 61605
|
| Min. Negotiated Rate |
$1,219.64 |
| Max. Negotiated Rate |
$3,772.30 |
| Rate for Payer: Aetna Commercial |
$2,793.41
|
| Rate for Payer: Aetna Medicare |
$2,433.00
|
| Rate for Payer: BCBS Complete |
$1,280.62
|
| Rate for Payer: BCN Commercial |
$3,247.83
|
| Rate for Payer: Cash Price |
$3,892.80
|
| Rate for Payer: Cash Price |
$3,892.80
|
| Rate for Payer: Mclaren Medicaid |
$1,219.64
|
| Rate for Payer: Meridian Medicaid |
$1,280.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,649.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,219.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,772.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,772.30
|
| Rate for Payer: UHC Medicaid |
$1,219.64
|
| Rate for Payer: UHCCP Medicaid |
$1,219.64
|
|
|
PR RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR
|
Professional
|
Both
|
$10,526.00
|
|
|
Service Code
|
HCPCS 61606
|
| Min. Negotiated Rate |
$1,739.78 |
| Max. Negotiated Rate |
$7,894.50 |
| Rate for Payer: Aetna Commercial |
$3,798.94
|
| Rate for Payer: Aetna Medicare |
$5,263.00
|
| Rate for Payer: BCBS Complete |
$1,826.77
|
| Rate for Payer: BCN Commercial |
$6,053.47
|
| Rate for Payer: Cash Price |
$8,420.80
|
| Rate for Payer: Cash Price |
$8,420.80
|
| Rate for Payer: Mclaren Medicaid |
$1,739.78
|
| Rate for Payer: Meridian Medicaid |
$1,826.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,894.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,739.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,089.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,089.31
|
| Rate for Payer: UHC Medicaid |
$1,739.78
|
| Rate for Payer: UHCCP Medicaid |
$1,739.78
|
|
