|
PR REMOVE DEEP SHOULDER FOREIGN BODY
|
Professional
|
Both
|
$1,039.00
|
|
|
Service Code
|
HCPCS 23331
|
| Min. Negotiated Rate |
$415.60 |
| Max. Negotiated Rate |
$675.35 |
| Rate for Payer: Aetna Medicare |
$519.50
|
| Rate for Payer: BCBS Complete |
$415.60
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.35
|
|
|
PR REMOVE INT DWELL URETERAL STENT TRANSURETHRAL
|
Professional
|
Both
|
$1,582.00
|
|
|
Service Code
|
HCPCS 50386
|
| Min. Negotiated Rate |
$103.09 |
| Max. Negotiated Rate |
$1,103.43 |
| Rate for Payer: Aetna Commercial |
$207.19
|
| Rate for Payer: Aetna Medicare |
$160.80
|
| Rate for Payer: BCBS Complete |
$108.24
|
| Rate for Payer: BCBS MAPPO |
$154.62
|
| Rate for Payer: BCN Commercial |
$1,103.43
|
| Rate for Payer: BCN Medicare Advantage |
$154.62
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cofinity Commercial |
$222.65
|
| Rate for Payer: Cofinity Commercial |
$207.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.62
|
| Rate for Payer: Mclaren Medicaid |
$103.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.35
|
| Rate for Payer: Meridian Medicaid |
$108.24
|
| Rate for Payer: Nomi Health Commercial |
$185.54
|
| Rate for Payer: PACE SWMI |
$154.62
|
| Rate for Payer: PHP Medicare Advantage |
$154.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,028.30
|
| Rate for Payer: Priority Health HMO/PPO |
$255.12
|
| Rate for Payer: Priority Health Medicare |
$156.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$255.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.62
|
| Rate for Payer: UHC Exchange |
$154.62
|
| Rate for Payer: UHC Medicare Advantage |
$154.62
|
| Rate for Payer: UHCCP Medicaid |
$103.09
|
|
|
PR REMOVE NAIL BED/FINGER TIP
|
Professional
|
Both
|
$530.00
|
|
|
Service Code
|
HCPCS 11752
|
| Min. Negotiated Rate |
$212.00 |
| Max. Negotiated Rate |
$344.50 |
| Rate for Payer: Aetna Medicare |
$265.00
|
| Rate for Payer: BCBS Complete |
$212.00
|
| Rate for Payer: Cash Price |
$424.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.50
|
|
|
PR REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL
|
Professional
|
Both
|
$2,093.00
|
|
|
Service Code
|
HCPCS 50385
|
| Min. Negotiated Rate |
$136.11 |
| Max. Negotiated Rate |
$2,060.90 |
| Rate for Payer: Aetna Commercial |
$274.16
|
| Rate for Payer: Aetna Medicare |
$212.78
|
| Rate for Payer: BCBS Complete |
$142.92
|
| Rate for Payer: BCBS MAPPO |
$204.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,060.90
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: BCN Medicare Advantage |
$204.60
|
| Rate for Payer: Cash Price |
$1,674.40
|
| Rate for Payer: Cash Price |
$1,674.40
|
| Rate for Payer: Cofinity Commercial |
$294.62
|
| Rate for Payer: Cofinity Commercial |
$274.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.60
|
| Rate for Payer: Mclaren Medicaid |
$136.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.83
|
| Rate for Payer: Meridian Medicaid |
$142.92
|
| Rate for Payer: Nomi Health Commercial |
$245.52
|
| Rate for Payer: PACE SWMI |
$204.60
|
| Rate for Payer: PHP Medicare Advantage |
$204.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,360.45
|
| Rate for Payer: Priority Health HMO/PPO |
$336.06
|
| Rate for Payer: Priority Health Medicare |
$206.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$336.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.60
|
| Rate for Payer: UHC Exchange |
$204.60
|
| Rate for Payer: UHC Medicare Advantage |
$204.60
|
| Rate for Payer: UHCCP Medicaid |
$136.11
|
|
|
PR REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,924.00
|
|
|
Service Code
|
HCPCS 53446
|
| Min. Negotiated Rate |
$413.01 |
| Max. Negotiated Rate |
$1,250.60 |
| Rate for Payer: Aetna Commercial |
$823.38
|
| Rate for Payer: Aetna Medicare |
$639.04
|
| Rate for Payer: BCBS Complete |
$433.66
|
| Rate for Payer: BCBS MAPPO |
$614.46
|
| Rate for Payer: BCBS Trust/PPO |
$437.96
|
| Rate for Payer: BCN Commercial |
$928.00
|
| Rate for Payer: BCN Medicare Advantage |
$614.46
|
| Rate for Payer: Cash Price |
$1,539.20
|
| Rate for Payer: Cash Price |
$1,539.20
|
| Rate for Payer: Cofinity Commercial |
$884.82
|
| Rate for Payer: Cofinity Commercial |
$823.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.46
|
| Rate for Payer: Mclaren Medicaid |
$413.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$645.18
|
| Rate for Payer: Meridian Medicaid |
$433.66
|
| Rate for Payer: Nomi Health Commercial |
$737.35
|
| Rate for Payer: PACE SWMI |
$614.46
|
| Rate for Payer: PHP Medicare Advantage |
$614.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,250.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,025.79
|
| Rate for Payer: Priority Health Medicare |
$620.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$614.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.46
|
| Rate for Payer: UHC Exchange |
$614.46
|
| Rate for Payer: UHC Medicare Advantage |
$614.46
|
| Rate for Payer: UHCCP Medicaid |
$413.01
|
|
|
PR REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 33227
|
| Min. Negotiated Rate |
$214.07 |
| Max. Negotiated Rate |
$1,104.68 |
| Rate for Payer: Aetna Commercial |
$430.49
|
| Rate for Payer: Aetna Medicare |
$334.11
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS MAPPO |
$321.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.68
|
| Rate for Payer: BCN Commercial |
$490.63
|
| Rate for Payer: BCN Medicare Advantage |
$321.26
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$462.61
|
| Rate for Payer: Cofinity Commercial |
$430.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.26
|
| Rate for Payer: Mclaren Medicaid |
$214.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.32
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Nomi Health Commercial |
$385.51
|
| Rate for Payer: PACE SWMI |
$321.26
|
| Rate for Payer: PHP Medicare Advantage |
$321.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$456.30
|
| Rate for Payer: Priority Health HMO/PPO |
$533.41
|
| Rate for Payer: Priority Health Medicare |
$324.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$533.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$321.26
|
| Rate for Payer: UHC Exchange |
$321.26
|
| Rate for Payer: UHC Medicare Advantage |
$321.26
|
| Rate for Payer: UHCCP Medicaid |
$214.07
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS
|
Professional
|
Both
|
$727.00
|
|
|
Service Code
|
HCPCS 33228
|
| Min. Negotiated Rate |
$224.08 |
| Max. Negotiated Rate |
$864.30 |
| Rate for Payer: Aetna Commercial |
$451.00
|
| Rate for Payer: Aetna Medicare |
$350.03
|
| Rate for Payer: BCBS Complete |
$235.28
|
| Rate for Payer: BCBS MAPPO |
$336.57
|
| Rate for Payer: BCBS Trust/PPO |
$864.30
|
| Rate for Payer: BCN Commercial |
$512.14
|
| Rate for Payer: BCN Medicare Advantage |
$336.57
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$484.66
|
| Rate for Payer: Cofinity Commercial |
$451.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.57
|
| Rate for Payer: Mclaren Medicaid |
$224.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.40
|
| Rate for Payer: Meridian Medicaid |
$235.28
|
| Rate for Payer: Nomi Health Commercial |
$403.88
|
| Rate for Payer: PACE SWMI |
$336.57
|
| Rate for Payer: PHP Medicare Advantage |
$336.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.55
|
| Rate for Payer: Priority Health HMO/PPO |
$556.82
|
| Rate for Payer: Priority Health Medicare |
$339.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$556.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$336.57
|
| Rate for Payer: UHC Exchange |
$336.57
|
| Rate for Payer: UHC Medicare Advantage |
$336.57
|
| Rate for Payer: UHCCP Medicaid |
$224.08
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD
|
Professional
|
Both
|
$578.00
|
|
|
Service Code
|
HCPCS 33229
|
| Min. Negotiated Rate |
$234.94 |
| Max. Negotiated Rate |
$1,010.11 |
| Rate for Payer: Aetna Commercial |
$472.63
|
| Rate for Payer: Aetna Medicare |
$366.82
|
| Rate for Payer: BCBS Complete |
$246.69
|
| Rate for Payer: BCBS MAPPO |
$352.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.11
|
| Rate for Payer: BCN Commercial |
$541.46
|
| Rate for Payer: BCN Medicare Advantage |
$352.71
|
| Rate for Payer: Cash Price |
$462.40
|
| Rate for Payer: Cash Price |
$462.40
|
| Rate for Payer: Cofinity Commercial |
$507.90
|
| Rate for Payer: Cofinity Commercial |
$472.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.71
|
| Rate for Payer: Mclaren Medicaid |
$234.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.35
|
| Rate for Payer: Meridian Medicaid |
$246.69
|
| Rate for Payer: Nomi Health Commercial |
$423.25
|
| Rate for Payer: PACE SWMI |
$352.71
|
| Rate for Payer: PHP Medicare Advantage |
$352.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.70
|
| Rate for Payer: Priority Health HMO/PPO |
$585.55
|
| Rate for Payer: Priority Health Medicare |
$356.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$585.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.71
|
| Rate for Payer: UHC Exchange |
$352.71
|
| Rate for Payer: UHC Medicare Advantage |
$352.71
|
| Rate for Payer: UHCCP Medicaid |
$234.94
|
|
|
PR REMV TISSUE FOR GRAFT OTHR
|
Professional
|
Both
|
$819.00
|
|
|
Service Code
|
HCPCS 20926
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$532.35 |
| Rate for Payer: Aetna Medicare |
$409.50
|
| Rate for Payer: BCBS Complete |
$327.60
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.35
|
|
|
PR RENAL ANGIO, CARDIAC CATH
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G0275
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
|
|
PR RENAL BIOPSY PRQ TROCAR/NEEDLE
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 50200
|
| Min. Negotiated Rate |
$79.66 |
| Max. Negotiated Rate |
$760.38 |
| Rate for Payer: Aetna Commercial |
$159.47
|
| Rate for Payer: Aetna Medicare |
$123.77
|
| Rate for Payer: BCBS Complete |
$83.64
|
| Rate for Payer: BCBS MAPPO |
$119.01
|
| Rate for Payer: BCN Commercial |
$760.38
|
| Rate for Payer: BCN Medicare Advantage |
$119.01
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$171.37
|
| Rate for Payer: Cofinity Commercial |
$159.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.01
|
| Rate for Payer: Mclaren Medicaid |
$79.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.96
|
| Rate for Payer: Meridian Medicaid |
$83.64
|
| Rate for Payer: Nomi Health Commercial |
$142.81
|
| Rate for Payer: PACE SWMI |
$119.01
|
| Rate for Payer: PHP Medicare Advantage |
$119.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO |
$198.13
|
| Rate for Payer: Priority Health Medicare |
$120.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.01
|
| Rate for Payer: UHC Exchange |
$119.01
|
| Rate for Payer: UHC Medicare Advantage |
$119.01
|
| Rate for Payer: UHCCP Medicaid |
$79.66
|
|
|
PR RENAL BIOPSY SURG EXPOSURE KIDNEY
|
Professional
|
Both
|
$1,699.00
|
|
|
Service Code
|
HCPCS 50205
|
| Min. Negotiated Rate |
$486.71 |
| Max. Negotiated Rate |
$2,575.99 |
| Rate for Payer: Aetna Commercial |
$982.61
|
| Rate for Payer: Aetna Medicare |
$762.62
|
| Rate for Payer: BCBS Complete |
$511.05
|
| Rate for Payer: BCBS MAPPO |
$733.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,575.99
|
| Rate for Payer: BCN Commercial |
$1,101.48
|
| Rate for Payer: BCN Medicare Advantage |
$733.29
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$982.61
|
| Rate for Payer: Cofinity Commercial |
$1,055.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$733.29
|
| Rate for Payer: Mclaren Medicaid |
$486.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$769.95
|
| Rate for Payer: Meridian Medicaid |
$511.05
|
| Rate for Payer: Nomi Health Commercial |
$879.95
|
| Rate for Payer: PACE SWMI |
$733.29
|
| Rate for Payer: PHP Medicare Advantage |
$733.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,104.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,209.54
|
| Rate for Payer: Priority Health Medicare |
$740.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,209.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$733.29
|
| Rate for Payer: UHC Exchange |
$733.29
|
| Rate for Payer: UHC Medicare Advantage |
$733.29
|
| Rate for Payer: UHCCP Medicaid |
$486.71
|
|
|
PR RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 50551
|
| Min. Negotiated Rate |
$185.74 |
| Max. Negotiated Rate |
$3,748.82 |
| Rate for Payer: Aetna Commercial |
$373.50
|
| Rate for Payer: Aetna Medicare |
$289.88
|
| Rate for Payer: BCBS Complete |
$195.03
|
| Rate for Payer: BCBS MAPPO |
$278.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,748.82
|
| Rate for Payer: BCN Commercial |
$522.88
|
| Rate for Payer: BCN Medicare Advantage |
$278.73
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$401.37
|
| Rate for Payer: Cofinity Commercial |
$373.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.73
|
| Rate for Payer: Mclaren Medicaid |
$185.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.67
|
| Rate for Payer: Meridian Medicaid |
$195.03
|
| Rate for Payer: Nomi Health Commercial |
$334.48
|
| Rate for Payer: PACE SWMI |
$278.73
|
| Rate for Payer: PHP Medicare Advantage |
$278.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.90
|
| Rate for Payer: Priority Health HMO/PPO |
$461.23
|
| Rate for Payer: Priority Health Medicare |
$281.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$278.73
|
| Rate for Payer: UHC Exchange |
$278.73
|
| Rate for Payer: UHC Medicare Advantage |
$278.73
|
| Rate for Payer: UHCCP Medicaid |
$185.74
|
|
|
PR RENAL EXPLORATION NOT NECESSITATING OTH SPEC PX
|
Professional
|
Both
|
$2,514.00
|
|
|
Service Code
|
HCPCS 50010
|
| Min. Negotiated Rate |
$452.20 |
| Max. Negotiated Rate |
$3,137.57 |
| Rate for Payer: Aetna Commercial |
$902.37
|
| Rate for Payer: Aetna Medicare |
$700.35
|
| Rate for Payer: BCBS Complete |
$474.81
|
| Rate for Payer: BCBS MAPPO |
$673.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,137.57
|
| Rate for Payer: BCN Commercial |
$1,082.91
|
| Rate for Payer: BCN Medicare Advantage |
$673.41
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cofinity Commercial |
$969.71
|
| Rate for Payer: Cofinity Commercial |
$902.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$673.41
|
| Rate for Payer: Mclaren Medicaid |
$452.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$707.08
|
| Rate for Payer: Meridian Medicaid |
$474.81
|
| Rate for Payer: Nomi Health Commercial |
$808.09
|
| Rate for Payer: PACE SWMI |
$673.41
|
| Rate for Payer: PHP Medicare Advantage |
$673.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,124.32
|
| Rate for Payer: Priority Health Medicare |
$680.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,124.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$673.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$673.41
|
| Rate for Payer: UHC Exchange |
$673.41
|
| Rate for Payer: UHC Medicare Advantage |
$673.41
|
| Rate for Payer: UHCCP Medicaid |
$452.20
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY
|
Professional
|
Both
|
$784.00
|
|
|
Service Code
|
HCPCS 50555
|
| Min. Negotiated Rate |
$215.77 |
| Max. Negotiated Rate |
$4,030.40 |
| Rate for Payer: Aetna Commercial |
$434.24
|
| Rate for Payer: Aetna Medicare |
$337.02
|
| Rate for Payer: BCBS Complete |
$226.56
|
| Rate for Payer: BCBS MAPPO |
$324.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,030.40
|
| Rate for Payer: BCN Commercial |
$595.70
|
| Rate for Payer: BCN Medicare Advantage |
$324.06
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cofinity Commercial |
$466.65
|
| Rate for Payer: Cofinity Commercial |
$434.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.06
|
| Rate for Payer: Mclaren Medicaid |
$215.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.26
|
| Rate for Payer: Meridian Medicaid |
$226.56
|
| Rate for Payer: Nomi Health Commercial |
$388.87
|
| Rate for Payer: PACE SWMI |
$324.06
|
| Rate for Payer: PHP Medicare Advantage |
$324.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.60
|
| Rate for Payer: Priority Health HMO/PPO |
$535.26
|
| Rate for Payer: Priority Health Medicare |
$327.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$535.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.06
|
| Rate for Payer: UHC Exchange |
$324.06
|
| Rate for Payer: UHC Medicare Advantage |
$324.06
|
| Rate for Payer: UHCCP Medicaid |
$215.77
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI
|
Professional
|
Both
|
$831.00
|
|
|
Service Code
|
HCPCS 50557
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$4,171.46 |
| Rate for Payer: Aetna Commercial |
$439.32
|
| Rate for Payer: Aetna Medicare |
$340.96
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS MAPPO |
$327.85
|
| Rate for Payer: BCBS Trust/PPO |
$4,171.46
|
| Rate for Payer: BCN Commercial |
$606.45
|
| Rate for Payer: BCN Medicare Advantage |
$327.85
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cofinity Commercial |
$472.10
|
| Rate for Payer: Cofinity Commercial |
$439.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.85
|
| Rate for Payer: Mclaren Medicaid |
$218.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.24
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Nomi Health Commercial |
$393.42
|
| Rate for Payer: PACE SWMI |
$327.85
|
| Rate for Payer: PHP Medicare Advantage |
$327.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$540.15
|
| Rate for Payer: Priority Health HMO/PPO |
$542.19
|
| Rate for Payer: Priority Health Medicare |
$331.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$542.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.85
|
| Rate for Payer: UHC Exchange |
$327.85
|
| Rate for Payer: UHC Medicare Advantage |
$327.85
|
| Rate for Payer: UHCCP Medicaid |
$218.33
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$908.00
|
|
|
Service Code
|
HCPCS 50561
|
| Min. Negotiated Rate |
$248.78 |
| Max. Negotiated Rate |
$687.57 |
| Rate for Payer: Aetna Commercial |
$500.78
|
| Rate for Payer: Aetna Medicare |
$388.67
|
| Rate for Payer: BCBS Complete |
$261.22
|
| Rate for Payer: BCBS MAPPO |
$373.72
|
| Rate for Payer: BCBS Trust/PPO |
$287.92
|
| Rate for Payer: BCN Commercial |
$687.57
|
| Rate for Payer: BCN Medicare Advantage |
$373.72
|
| Rate for Payer: Cash Price |
$726.40
|
| Rate for Payer: Cash Price |
$726.40
|
| Rate for Payer: Cofinity Commercial |
$538.16
|
| Rate for Payer: Cofinity Commercial |
$500.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.72
|
| Rate for Payer: Mclaren Medicaid |
$248.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.41
|
| Rate for Payer: Meridian Medicaid |
$261.22
|
| Rate for Payer: Nomi Health Commercial |
$448.46
|
| Rate for Payer: PACE SWMI |
$373.72
|
| Rate for Payer: PHP Medicare Advantage |
$373.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.20
|
| Rate for Payer: Priority Health HMO/PPO |
$619.41
|
| Rate for Payer: Priority Health Medicare |
$377.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.72
|
| Rate for Payer: UHC Exchange |
$373.72
|
| Rate for Payer: UHC Medicare Advantage |
$373.72
|
| Rate for Payer: UHCCP Medicaid |
$248.78
|
|
|
PR RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 50553
|
| Min. Negotiated Rate |
$198.30 |
| Max. Negotiated Rate |
$3,834.93 |
| Rate for Payer: Aetna Commercial |
$398.76
|
| Rate for Payer: Aetna Medicare |
$309.48
|
| Rate for Payer: BCBS Complete |
$208.22
|
| Rate for Payer: BCBS MAPPO |
$297.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,834.93
|
| Rate for Payer: BCN Commercial |
$560.51
|
| Rate for Payer: BCN Medicare Advantage |
$297.58
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$428.52
|
| Rate for Payer: Cofinity Commercial |
$398.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.58
|
| Rate for Payer: Mclaren Medicaid |
$198.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.46
|
| Rate for Payer: Meridian Medicaid |
$208.22
|
| Rate for Payer: Nomi Health Commercial |
$357.10
|
| Rate for Payer: PACE SWMI |
$297.58
|
| Rate for Payer: PHP Medicare Advantage |
$297.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.90
|
| Rate for Payer: Priority Health HMO/PPO |
$493.18
|
| Rate for Payer: Priority Health Medicare |
$300.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.58
|
| Rate for Payer: UHC Exchange |
$297.58
|
| Rate for Payer: UHC Medicare Advantage |
$297.58
|
| Rate for Payer: UHCCP Medicaid |
$198.30
|
|
|
PR RENAL NDSC NEPHROTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
HCPCS 50570
|
| Min. Negotiated Rate |
$309.70 |
| Max. Negotiated Rate |
$770.67 |
| Rate for Payer: Aetna Commercial |
$623.96
|
| Rate for Payer: Aetna Medicare |
$484.27
|
| Rate for Payer: BCBS Complete |
$325.18
|
| Rate for Payer: BCBS MAPPO |
$465.64
|
| Rate for Payer: BCBS Trust/PPO |
$634.49
|
| Rate for Payer: BCN Commercial |
$699.30
|
| Rate for Payer: BCN Medicare Advantage |
$465.64
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cofinity Commercial |
$670.52
|
| Rate for Payer: Cofinity Commercial |
$623.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.64
|
| Rate for Payer: Mclaren Medicaid |
$309.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.92
|
| Rate for Payer: Meridian Medicaid |
$325.18
|
| Rate for Payer: Nomi Health Commercial |
$558.77
|
| Rate for Payer: PACE SWMI |
$465.64
|
| Rate for Payer: PHP Medicare Advantage |
$465.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.10
|
| Rate for Payer: Priority Health HMO/PPO |
$770.67
|
| Rate for Payer: Priority Health Medicare |
$470.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$770.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$465.64
|
| Rate for Payer: UHC Exchange |
$465.64
|
| Rate for Payer: UHC Medicare Advantage |
$465.64
|
| Rate for Payer: UHCCP Medicaid |
$309.70
|
|
|
PR REOPENING RECENT LAPAROTOMY
|
Professional
|
Both
|
$2,127.00
|
|
|
Service Code
|
HCPCS 49002
|
| Min. Negotiated Rate |
$611.24 |
| Max. Negotiated Rate |
$1,863.76 |
| Rate for Payer: Aetna Commercial |
$1,356.37
|
| Rate for Payer: Aetna Medicare |
$1,052.71
|
| Rate for Payer: BCBS Complete |
$702.71
|
| Rate for Payer: BCBS MAPPO |
$1,012.22
|
| Rate for Payer: BCBS Trust/PPO |
$611.24
|
| Rate for Payer: BCN Commercial |
$1,518.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,012.22
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cofinity Commercial |
$1,457.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,012.22
|
| Rate for Payer: Mclaren Medicaid |
$669.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,062.83
|
| Rate for Payer: Meridian Medicaid |
$702.71
|
| Rate for Payer: Nomi Health Commercial |
$1,214.66
|
| Rate for Payer: PACE SWMI |
$1,012.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,012.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$669.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.76
|
| Rate for Payer: Priority Health Medicare |
$1,022.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,863.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,012.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,012.22
|
| Rate for Payer: UHC Exchange |
$1,012.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,012.22
|
| Rate for Payer: UHCCP Medicaid |
$669.25
|
|
|
PR REPAIR ANAL FISTULA W/FIBRIN GLUE
|
Professional
|
Both
|
$341.00
|
|
|
Service Code
|
HCPCS 46706
|
| Min. Negotiated Rate |
$117.58 |
| Max. Negotiated Rate |
$325.15 |
| Rate for Payer: Aetna Commercial |
$234.53
|
| Rate for Payer: Aetna Medicare |
$182.02
|
| Rate for Payer: BCBS Complete |
$123.46
|
| Rate for Payer: BCBS MAPPO |
$175.02
|
| Rate for Payer: BCBS Trust/PPO |
$169.58
|
| Rate for Payer: BCN Commercial |
$262.91
|
| Rate for Payer: BCN Medicare Advantage |
$175.02
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cofinity Commercial |
$252.03
|
| Rate for Payer: Cofinity Commercial |
$234.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.02
|
| Rate for Payer: Mclaren Medicaid |
$117.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.77
|
| Rate for Payer: Meridian Medicaid |
$123.46
|
| Rate for Payer: Nomi Health Commercial |
$210.02
|
| Rate for Payer: PACE SWMI |
$175.02
|
| Rate for Payer: PHP Medicare Advantage |
$175.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.65
|
| Rate for Payer: Priority Health HMO/PPO |
$325.15
|
| Rate for Payer: Priority Health Medicare |
$176.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.02
|
| Rate for Payer: UHC Exchange |
$175.02
|
| Rate for Payer: UHC Medicare Advantage |
$175.02
|
| Rate for Payer: UHCCP Medicaid |
$117.58
|
|
|
PR REPAIR ANORECTAL FISTULA PLUG
|
Professional
|
Both
|
$1,037.00
|
|
|
Service Code
|
HCPCS 46707
|
| Min. Negotiated Rate |
$192.83 |
| Max. Negotiated Rate |
$910.41 |
| Rate for Payer: Aetna Commercial |
$652.96
|
| Rate for Payer: Aetna Medicare |
$506.77
|
| Rate for Payer: BCBS Complete |
$345.31
|
| Rate for Payer: BCBS MAPPO |
$487.28
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$741.32
|
| Rate for Payer: BCN Medicare Advantage |
$487.28
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cofinity Commercial |
$701.68
|
| Rate for Payer: Cofinity Commercial |
$652.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.28
|
| Rate for Payer: Mclaren Medicaid |
$328.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.64
|
| Rate for Payer: Meridian Medicaid |
$345.31
|
| Rate for Payer: Nomi Health Commercial |
$584.74
|
| Rate for Payer: PACE SWMI |
$487.28
|
| Rate for Payer: PHP Medicare Advantage |
$487.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.05
|
| Rate for Payer: Priority Health HMO/PPO |
$910.41
|
| Rate for Payer: Priority Health Medicare |
$492.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$910.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.28
|
| Rate for Payer: UHC Exchange |
$487.28
|
| Rate for Payer: UHC Medicare Advantage |
$487.28
|
| Rate for Payer: UHCCP Medicaid |
$328.87
|
|
|
PR REPAIR BIFID EARLOBES - BILATERAL
|
Professional
|
Both
|
$1,020.00
|
|
|
Service Code
|
HCPCS 00535
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$408.00 |
| Max. Negotiated Rate |
$663.00 |
| Rate for Payer: Aetna Medicare |
$510.00
|
| Rate for Payer: BCBS Complete |
$408.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.00
|
|
|
PR REPAIR BIFID EARLOBES - UNILATERAL
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 00534
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$244.80 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: Aetna Medicare |
$306.00
|
| Rate for Payer: BCBS Complete |
$244.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
|
|
PR REPAIR BLOOD VESSEL DIRECT HAND FINGER
|
Professional
|
Both
|
$1,353.00
|
|
|
Service Code
|
HCPCS 35207
|
| Min. Negotiated Rate |
$292.68 |
| Max. Negotiated Rate |
$1,209.90 |
| Rate for Payer: Aetna Commercial |
$972.95
|
| Rate for Payer: Aetna Medicare |
$755.12
|
| Rate for Payer: BCBS Complete |
$514.17
|
| Rate for Payer: BCBS MAPPO |
$726.08
|
| Rate for Payer: BCBS Trust/PPO |
$292.68
|
| Rate for Payer: BCN Commercial |
$1,109.79
|
| Rate for Payer: BCN Medicare Advantage |
$726.08
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$972.95
|
| Rate for Payer: Cofinity Commercial |
$1,045.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$726.08
|
| Rate for Payer: Mclaren Medicaid |
$489.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$762.38
|
| Rate for Payer: Meridian Medicaid |
$514.17
|
| Rate for Payer: Nomi Health Commercial |
$871.30
|
| Rate for Payer: PACE SWMI |
$726.08
|
| Rate for Payer: PHP Medicare Advantage |
$726.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,209.90
|
| Rate for Payer: Priority Health Medicare |
$733.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,209.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$726.08
|
| Rate for Payer: UHC Exchange |
$726.08
|
| Rate for Payer: UHC Medicare Advantage |
$726.08
|
| Rate for Payer: UHCCP Medicaid |
$489.69
|
|
