|
PR REVISION OF LARYNX, UNSPECIFIED
|
Professional
|
Both
|
$2,122.00
|
|
|
Service Code
|
HCPCS 31588
|
| Min. Negotiated Rate |
$848.80 |
| Max. Negotiated Rate |
$1,591.50 |
| Rate for Payer: Aetna Medicare |
$1,061.00
|
| Rate for Payer: BCBS Complete |
$848.80
|
| Rate for Payer: Cash Price |
$1,697.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,591.50
|
|
|
PR REVISION OF RECONSTRUCTED BREAST
|
Professional
|
Both
|
$1,255.00
|
|
|
Service Code
|
HCPCS 19380
|
| Min. Negotiated Rate |
$469.24 |
| Max. Negotiated Rate |
$1,222.54 |
| Rate for Payer: Aetna Commercial |
$872.03
|
| Rate for Payer: Aetna Medicare |
$627.50
|
| Rate for Payer: BCBS Complete |
$492.70
|
| Rate for Payer: BCN Commercial |
$1,222.54
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Mclaren Medicaid |
$469.24
|
| Rate for Payer: Meridian Medicaid |
$492.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$941.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,118.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,118.95
|
| Rate for Payer: UHC Medicaid |
$469.24
|
| Rate for Payer: UHCCP Medicaid |
$469.24
|
|
|
PR REVISION PERI-IMPLANT CAPSULE BREAST
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 19370
|
| Min. Negotiated Rate |
$392.77 |
| Max. Negotiated Rate |
$1,018.37 |
| Rate for Payer: Aetna Commercial |
$723.37
|
| Rate for Payer: Aetna Medicare |
$640.50
|
| Rate for Payer: BCBS Complete |
$412.41
|
| Rate for Payer: BCN Commercial |
$1,018.37
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Mclaren Medicaid |
$392.77
|
| Rate for Payer: Meridian Medicaid |
$412.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$932.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$932.08
|
| Rate for Payer: UHC Medicaid |
$392.77
|
| Rate for Payer: UHCCP Medicaid |
$392.77
|
|
|
PR REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC
|
Professional
|
Both
|
$1,660.00
|
|
|
Service Code
|
HCPCS 57426
|
| Min. Negotiated Rate |
$494.80 |
| Max. Negotiated Rate |
$1,325.93 |
| Rate for Payer: Aetna Commercial |
$1,034.70
|
| Rate for Payer: Aetna Medicare |
$830.00
|
| Rate for Payer: BCBS Complete |
$519.54
|
| Rate for Payer: BCN Commercial |
$1,309.20
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Mclaren Medicaid |
$494.80
|
| Rate for Payer: Meridian Medicaid |
$519.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,245.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,325.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,325.93
|
| Rate for Payer: UHC Medicaid |
$494.80
|
| Rate for Payer: UHCCP Medicaid |
$494.80
|
|
|
PR REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV
|
Professional
|
Both
|
$2,297.00
|
|
|
Service Code
|
HCPCS 64569
|
| Min. Negotiated Rate |
$475.84 |
| Max. Negotiated Rate |
$1,722.75 |
| Rate for Payer: Aetna Commercial |
$983.52
|
| Rate for Payer: Aetna Medicare |
$1,148.50
|
| Rate for Payer: BCBS Complete |
$499.63
|
| Rate for Payer: BCN Commercial |
$1,178.72
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Mclaren Medicaid |
$475.84
|
| Rate for Payer: Meridian Medicaid |
$499.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,369.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,369.06
|
| Rate for Payer: UHC Medicaid |
$475.84
|
| Rate for Payer: UHCCP Medicaid |
$475.84
|
|
|
PR REVISION STAPEDECTOMY/STAPEDOTOMY
|
Professional
|
Both
|
$4,035.00
|
|
|
Service Code
|
HCPCS 69662
|
| Min. Negotiated Rate |
$650.72 |
| Max. Negotiated Rate |
$3,026.25 |
| Rate for Payer: Aetna Commercial |
$1,316.73
|
| Rate for Payer: Aetna Medicare |
$2,017.50
|
| Rate for Payer: BCBS Complete |
$683.26
|
| Rate for Payer: BCN Commercial |
$1,718.53
|
| Rate for Payer: Cash Price |
$3,228.00
|
| Rate for Payer: Cash Price |
$3,228.00
|
| Rate for Payer: Mclaren Medicaid |
$650.72
|
| Rate for Payer: Meridian Medicaid |
$683.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,026.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,698.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,698.08
|
| Rate for Payer: UHC Medicaid |
$650.72
|
| Rate for Payer: UHCCP Medicaid |
$650.72
|
|
|
PR REVISION TRACHEOSTOMY SCAR
|
Professional
|
Both
|
$718.00
|
|
|
Service Code
|
HCPCS 31830
|
| Min. Negotiated Rate |
$211.08 |
| Max. Negotiated Rate |
$554.25 |
| Rate for Payer: Aetna Commercial |
$454.84
|
| Rate for Payer: Aetna Medicare |
$359.00
|
| Rate for Payer: BCBS Complete |
$221.63
|
| Rate for Payer: BCN Commercial |
$554.25
|
| Rate for Payer: Cash Price |
$574.40
|
| Rate for Payer: Cash Price |
$574.40
|
| Rate for Payer: Mclaren Medicaid |
$211.08
|
| Rate for Payer: Meridian Medicaid |
$221.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$538.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$521.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$521.95
|
| Rate for Payer: UHC Medicaid |
$211.08
|
| Rate for Payer: UHCCP Medicaid |
$211.08
|
|
|
PR REVIS PERITONEAL-VENOUS SHUNT
|
Professional
|
Both
|
$2,122.00
|
|
|
Service Code
|
HCPCS 49426
|
| Min. Negotiated Rate |
$409.81 |
| Max. Negotiated Rate |
$1,591.50 |
| Rate for Payer: Aetna Commercial |
$903.18
|
| Rate for Payer: Aetna Medicare |
$1,061.00
|
| Rate for Payer: BCBS Complete |
$430.30
|
| Rate for Payer: BCN Commercial |
$1,013.39
|
| Rate for Payer: Cash Price |
$1,697.60
|
| Rate for Payer: Cash Price |
$1,697.60
|
| Rate for Payer: Mclaren Medicaid |
$409.81
|
| Rate for Payer: Meridian Medicaid |
$430.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,591.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,234.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,234.75
|
| Rate for Payer: UHC Medicaid |
$409.81
|
| Rate for Payer: UHCCP Medicaid |
$409.81
|
|
|
PR REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT
|
Professional
|
Both
|
$4,318.00
|
|
|
Service Code
|
HCPCS 23474
|
| Min. Negotiated Rate |
$989.81 |
| Max. Negotiated Rate |
$3,238.50 |
| Rate for Payer: Aetna Commercial |
$2,333.04
|
| Rate for Payer: Aetna Medicare |
$2,159.00
|
| Rate for Payer: BCBS Complete |
$1,039.30
|
| Rate for Payer: BCN Commercial |
$2,612.90
|
| Rate for Payer: Cash Price |
$3,454.40
|
| Rate for Payer: Cash Price |
$3,454.40
|
| Rate for Payer: Mclaren Medicaid |
$989.81
|
| Rate for Payer: Meridian Medicaid |
$1,039.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,238.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$989.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,793.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,793.12
|
| Rate for Payer: UHC Medicaid |
$989.81
|
| Rate for Payer: UHCCP Medicaid |
$989.81
|
|
|
PR REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT
|
Professional
|
Both
|
$3,694.00
|
|
|
Service Code
|
HCPCS 23473
|
| Min. Negotiated Rate |
$918.46 |
| Max. Negotiated Rate |
$2,770.50 |
| Rate for Payer: Aetna Commercial |
$2,162.95
|
| Rate for Payer: Aetna Medicare |
$1,847.00
|
| Rate for Payer: BCBS Complete |
$964.38
|
| Rate for Payer: BCN Commercial |
$2,421.18
|
| Rate for Payer: Cash Price |
$2,955.20
|
| Rate for Payer: Cash Price |
$2,955.20
|
| Rate for Payer: Mclaren Medicaid |
$918.46
|
| Rate for Payer: Meridian Medicaid |
$964.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,770.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$918.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,588.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,588.18
|
| Rate for Payer: UHC Medicaid |
$918.46
|
| Rate for Payer: UHCCP Medicaid |
$918.46
|
|
|
PR REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT
|
Professional
|
Both
|
$2,145.00
|
|
|
Service Code
|
HCPCS 25449
|
| Min. Negotiated Rate |
$594.48 |
| Max. Negotiated Rate |
$1,677.89 |
| Rate for Payer: Aetna Commercial |
$1,378.02
|
| Rate for Payer: Aetna Medicare |
$1,072.50
|
| Rate for Payer: BCBS Complete |
$624.20
|
| Rate for Payer: BCN Commercial |
$1,569.64
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Mclaren Medicaid |
$594.48
|
| Rate for Payer: Meridian Medicaid |
$624.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,608.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,677.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,677.89
|
| Rate for Payer: UHC Medicaid |
$594.48
|
| Rate for Payer: UHCCP Medicaid |
$594.48
|
|
|
PR REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX
|
Professional
|
Both
|
$2,189.00
|
|
|
Service Code
|
HCPCS 44345
|
| Min. Negotiated Rate |
$629.20 |
| Max. Negotiated Rate |
$1,921.59 |
| Rate for Payer: Aetna Commercial |
$1,408.79
|
| Rate for Payer: Aetna Medicare |
$1,094.50
|
| Rate for Payer: BCBS Complete |
$660.66
|
| Rate for Payer: BCN Commercial |
$1,577.10
|
| Rate for Payer: Cash Price |
$1,751.20
|
| Rate for Payer: Cash Price |
$1,751.20
|
| Rate for Payer: Mclaren Medicaid |
$629.20
|
| Rate for Payer: Meridian Medicaid |
$660.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,641.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,921.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,921.59
|
| Rate for Payer: UHC Medicaid |
$629.20
|
| Rate for Payer: UHCCP Medicaid |
$629.20
|
|
|
PR REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 44340
|
| Min. Negotiated Rate |
$387.23 |
| Max. Negotiated Rate |
$1,153.45 |
| Rate for Payer: Aetna Commercial |
$833.87
|
| Rate for Payer: Aetna Medicare |
$573.50
|
| Rate for Payer: BCBS Complete |
$406.59
|
| Rate for Payer: BCN Commercial |
$946.66
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Mclaren Medicaid |
$387.23
|
| Rate for Payer: Meridian Medicaid |
$406.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,153.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,153.45
|
| Rate for Payer: UHC Medicaid |
$387.23
|
| Rate for Payer: UHCCP Medicaid |
$387.23
|
|
|
PR REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX
|
Professional
|
Both
|
$2,947.00
|
|
|
Service Code
|
HCPCS 44346
|
| Min. Negotiated Rate |
$701.62 |
| Max. Negotiated Rate |
$2,210.25 |
| Rate for Payer: Aetna Commercial |
$1,590.78
|
| Rate for Payer: Aetna Medicare |
$1,473.50
|
| Rate for Payer: BCBS Complete |
$736.70
|
| Rate for Payer: BCN Commercial |
$1,773.31
|
| Rate for Payer: Cash Price |
$2,357.60
|
| Rate for Payer: Cash Price |
$2,357.60
|
| Rate for Payer: Mclaren Medicaid |
$701.62
|
| Rate for Payer: Meridian Medicaid |
$736.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,210.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$701.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,160.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,160.67
|
| Rate for Payer: UHC Medicaid |
$701.62
|
| Rate for Payer: UHCCP Medicaid |
$701.62
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/AUTOG VN PATCH GRF
|
Professional
|
Both
|
$2,698.00
|
|
|
Service Code
|
HCPCS 35884
|
| Min. Negotiated Rate |
$718.88 |
| Max. Negotiated Rate |
$2,023.50 |
| Rate for Payer: Aetna Commercial |
$1,667.74
|
| Rate for Payer: Aetna Medicare |
$1,349.00
|
| Rate for Payer: BCBS Complete |
$754.82
|
| Rate for Payer: BCN Commercial |
$1,810.66
|
| Rate for Payer: Cash Price |
$2,158.40
|
| Rate for Payer: Cash Price |
$2,158.40
|
| Rate for Payer: Mclaren Medicaid |
$718.88
|
| Rate for Payer: Meridian Medicaid |
$754.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,023.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$718.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,947.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,947.14
|
| Rate for Payer: UHC Medicaid |
$718.88
|
| Rate for Payer: UHCCP Medicaid |
$718.88
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF
|
Professional
|
Both
|
$2,433.00
|
|
|
Service Code
|
HCPCS 35883
|
| Min. Negotiated Rate |
$690.97 |
| Max. Negotiated Rate |
$1,873.23 |
| Rate for Payer: Aetna Commercial |
$1,617.26
|
| Rate for Payer: Aetna Medicare |
$1,216.50
|
| Rate for Payer: BCBS Complete |
$725.52
|
| Rate for Payer: BCN Commercial |
$1,741.93
|
| Rate for Payer: Cash Price |
$1,946.40
|
| Rate for Payer: Cash Price |
$1,946.40
|
| Rate for Payer: Mclaren Medicaid |
$690.97
|
| Rate for Payer: Meridian Medicaid |
$725.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,824.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,873.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,873.23
|
| Rate for Payer: UHC Medicaid |
$690.97
|
| Rate for Payer: UHCCP Medicaid |
$690.97
|
|
|
PR REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY
|
Professional
|
Both
|
$5,546.00
|
|
|
Service Code
|
HCPCS 43860
|
| Min. Negotiated Rate |
$966.81 |
| Max. Negotiated Rate |
$4,159.50 |
| Rate for Payer: Aetna Commercial |
$2,208.98
|
| Rate for Payer: Aetna Medicare |
$2,773.00
|
| Rate for Payer: BCBS Complete |
$1,015.15
|
| Rate for Payer: BCN Commercial |
$2,455.05
|
| Rate for Payer: Cash Price |
$4,436.80
|
| Rate for Payer: Cash Price |
$4,436.80
|
| Rate for Payer: Mclaren Medicaid |
$966.81
|
| Rate for Payer: Meridian Medicaid |
$1,015.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,159.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$966.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,991.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,991.31
|
| Rate for Payer: UHC Medicaid |
$966.81
|
| Rate for Payer: UHCCP Medicaid |
$966.81
|
|
|
PR REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX
|
Professional
|
Both
|
$2,665.00
|
|
|
Service Code
|
HCPCS 44314
|
| Min. Negotiated Rate |
$596.61 |
| Max. Negotiated Rate |
$1,998.75 |
| Rate for Payer: Aetna Commercial |
$1,349.17
|
| Rate for Payer: Aetna Medicare |
$1,332.50
|
| Rate for Payer: BCBS Complete |
$626.44
|
| Rate for Payer: BCN Commercial |
$1,502.40
|
| Rate for Payer: Cash Price |
$2,132.00
|
| Rate for Payer: Cash Price |
$2,132.00
|
| Rate for Payer: Mclaren Medicaid |
$596.61
|
| Rate for Payer: Meridian Medicaid |
$626.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,998.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$596.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,830.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,830.58
|
| Rate for Payer: UHC Medicaid |
$596.61
|
| Rate for Payer: UHCCP Medicaid |
$596.61
|
|
|
PR REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX
|
Professional
|
Both
|
$1,275.00
|
|
|
Service Code
|
HCPCS 44312
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,095.19 |
| Rate for Payer: Aetna Commercial |
$799.15
|
| Rate for Payer: Aetna Medicare |
$637.50
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCN Commercial |
$898.85
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Mclaren Medicaid |
$362.31
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$956.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,095.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,095.19
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR
|
Professional
|
Both
|
$4,252.00
|
|
|
Service Code
|
HCPCS 63664
|
| Min. Negotiated Rate |
$565.30 |
| Max. Negotiated Rate |
$3,189.00 |
| Rate for Payer: Aetna Commercial |
$1,132.94
|
| Rate for Payer: Aetna Medicare |
$2,126.00
|
| Rate for Payer: BCBS Complete |
$593.57
|
| Rate for Payer: BCN Commercial |
$1,356.50
|
| Rate for Payer: Cash Price |
$3,401.60
|
| Rate for Payer: Cash Price |
$3,401.60
|
| Rate for Payer: Mclaren Medicaid |
$565.30
|
| Rate for Payer: Meridian Medicaid |
$593.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,189.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$565.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,575.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,575.55
|
| Rate for Payer: UHC Medicaid |
$565.30
|
| Rate for Payer: UHCCP Medicaid |
$565.30
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR
|
Professional
|
Both
|
$4,962.00
|
|
|
Service Code
|
HCPCS 63663
|
| Min. Negotiated Rate |
$261.14 |
| Max. Negotiated Rate |
$3,721.50 |
| Rate for Payer: Aetna Commercial |
$582.45
|
| Rate for Payer: Aetna Medicare |
$2,481.00
|
| Rate for Payer: BCBS Complete |
$274.20
|
| Rate for Payer: BCN Commercial |
$676.26
|
| Rate for Payer: Cash Price |
$3,969.60
|
| Rate for Payer: Cash Price |
$3,969.60
|
| Rate for Payer: Mclaren Medicaid |
$261.14
|
| Rate for Payer: Meridian Medicaid |
$274.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,721.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$785.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$785.47
|
| Rate for Payer: UHC Medicaid |
$261.14
|
| Rate for Payer: UHCCP Medicaid |
$261.14
|
|
|
PR REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP
|
Professional
|
Both
|
$1,880.00
|
|
|
Service Code
|
HCPCS 35879
|
| Min. Negotiated Rate |
$536.33 |
| Max. Negotiated Rate |
$1,450.17 |
| Rate for Payer: Aetna Commercial |
$1,239.03
|
| Rate for Payer: Aetna Medicare |
$940.00
|
| Rate for Payer: BCBS Complete |
$563.15
|
| Rate for Payer: BCN Commercial |
$1,348.53
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Mclaren Medicaid |
$536.33
|
| Rate for Payer: Meridian Medicaid |
$563.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,410.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,450.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,450.17
|
| Rate for Payer: UHC Medicaid |
$536.33
|
| Rate for Payer: UHCCP Medicaid |
$536.33
|
|
|
PR REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS
|
Professional
|
Both
|
$2,183.00
|
|
|
Service Code
|
HCPCS 35881
|
| Min. Negotiated Rate |
$595.97 |
| Max. Negotiated Rate |
$1,637.25 |
| Rate for Payer: Aetna Commercial |
$1,373.12
|
| Rate for Payer: Aetna Medicare |
$1,091.50
|
| Rate for Payer: BCBS Complete |
$625.77
|
| Rate for Payer: BCN Commercial |
$1,495.93
|
| Rate for Payer: Cash Price |
$1,746.40
|
| Rate for Payer: Cash Price |
$1,746.40
|
| Rate for Payer: Mclaren Medicaid |
$595.97
|
| Rate for Payer: Meridian Medicaid |
$625.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,637.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,608.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,608.69
|
| Rate for Payer: UHC Medicaid |
$595.97
|
| Rate for Payer: UHCCP Medicaid |
$595.97
|
|
|
PR REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 69601
|
| Min. Negotiated Rate |
$577.23 |
| Max. Negotiated Rate |
$1,612.50 |
| Rate for Payer: Aetna Commercial |
$1,166.54
|
| Rate for Payer: Aetna Medicare |
$1,075.00
|
| Rate for Payer: BCBS Complete |
$606.09
|
| Rate for Payer: BCN Commercial |
$1,519.84
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Mclaren Medicaid |
$577.23
|
| Rate for Payer: Meridian Medicaid |
$606.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$577.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,501.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,501.76
|
| Rate for Payer: UHC Medicaid |
$577.23
|
| Rate for Payer: UHCCP Medicaid |
$577.23
|
|
|
PR REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY
|
Professional
|
Both
|
$2,306.00
|
|
|
Service Code
|
HCPCS 69604
|
| Min. Negotiated Rate |
$628.99 |
| Max. Negotiated Rate |
$1,729.50 |
| Rate for Payer: Aetna Commercial |
$1,264.88
|
| Rate for Payer: Aetna Medicare |
$1,153.00
|
| Rate for Payer: BCBS Complete |
$660.44
|
| Rate for Payer: BCN Commercial |
$1,658.77
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Mclaren Medicaid |
$628.99
|
| Rate for Payer: Meridian Medicaid |
$660.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,729.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,639.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,639.03
|
| Rate for Payer: UHC Medicaid |
$628.99
|
| Rate for Payer: UHCCP Medicaid |
$628.99
|
|
