|
PR RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP
|
Professional
|
Both
|
$6,715.00
|
|
|
Service Code
|
HCPCS 35241
|
| Min. Negotiated Rate |
$873.73 |
| Max. Negotiated Rate |
$5,036.25 |
| Rate for Payer: Aetna Commercial |
$1,926.86
|
| Rate for Payer: Aetna Medicare |
$3,357.50
|
| Rate for Payer: BCBS Complete |
$917.42
|
| Rate for Payer: BCN Commercial |
$2,110.44
|
| Rate for Payer: Cash Price |
$5,372.00
|
| Rate for Payer: Cash Price |
$5,372.00
|
| Rate for Payer: Mclaren Medicaid |
$873.73
|
| Rate for Payer: Meridian Medicaid |
$917.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,036.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$873.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,269.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,269.51
|
| Rate for Payer: UHC Medicaid |
$873.73
|
| Rate for Payer: UHCCP Medicaid |
$873.73
|
|
|
PR RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP
|
Professional
|
Both
|
$6,946.00
|
|
|
Service Code
|
HCPCS 35271
|
| Min. Negotiated Rate |
$843.27 |
| Max. Negotiated Rate |
$5,209.50 |
| Rate for Payer: Aetna Commercial |
$1,857.88
|
| Rate for Payer: Aetna Medicare |
$3,473.00
|
| Rate for Payer: BCBS Complete |
$885.43
|
| Rate for Payer: BCN Commercial |
$2,033.76
|
| Rate for Payer: Cash Price |
$5,556.80
|
| Rate for Payer: Cash Price |
$5,556.80
|
| Rate for Payer: Mclaren Medicaid |
$843.27
|
| Rate for Payer: Meridian Medicaid |
$885.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,209.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$843.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,187.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,187.04
|
| Rate for Payer: UHC Medicaid |
$843.27
|
| Rate for Payer: UHCCP Medicaid |
$843.27
|
|
|
PR RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 35266
|
| Min. Negotiated Rate |
$502.47 |
| Max. Negotiated Rate |
$1,385.25 |
| Rate for Payer: Aetna Commercial |
$1,163.16
|
| Rate for Payer: Aetna Medicare |
$923.50
|
| Rate for Payer: BCBS Complete |
$527.59
|
| Rate for Payer: BCN Commercial |
$1,271.84
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Mclaren Medicaid |
$502.47
|
| Rate for Payer: Meridian Medicaid |
$527.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,385.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,367.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,367.71
|
| Rate for Payer: UHC Medicaid |
$502.47
|
| Rate for Payer: UHCCP Medicaid |
$502.47
|
|
|
PR RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY
|
Professional
|
Both
|
$3,906.00
|
|
|
Service Code
|
HCPCS 35286
|
| Min. Negotiated Rate |
$536.76 |
| Max. Negotiated Rate |
$2,929.50 |
| Rate for Payer: Aetna Commercial |
$1,253.73
|
| Rate for Payer: Aetna Medicare |
$1,953.00
|
| Rate for Payer: BCBS Complete |
$563.60
|
| Rate for Payer: BCN Commercial |
$1,357.50
|
| Rate for Payer: Cash Price |
$3,124.80
|
| Rate for Payer: Cash Price |
$3,124.80
|
| Rate for Payer: Mclaren Medicaid |
$536.76
|
| Rate for Payer: Meridian Medicaid |
$563.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,929.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,459.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,459.82
|
| Rate for Payer: UHC Medicaid |
$536.76
|
| Rate for Payer: UHCCP Medicaid |
$536.76
|
|
|
PR RPR CLOACAL ANOMALY SACROPERINEAL
|
Professional
|
Both
|
$6,780.00
|
|
|
Service Code
|
HCPCS 46744
|
| Min. Negotiated Rate |
$2,107.00 |
| Max. Negotiated Rate |
$6,461.36 |
| Rate for Payer: Aetna Commercial |
$4,778.09
|
| Rate for Payer: Aetna Medicare |
$3,390.00
|
| Rate for Payer: BCBS Complete |
$2,212.35
|
| Rate for Payer: BCN Commercial |
$5,303.00
|
| Rate for Payer: Cash Price |
$5,424.00
|
| Rate for Payer: Cash Price |
$5,424.00
|
| Rate for Payer: Mclaren Medicaid |
$2,107.00
|
| Rate for Payer: Meridian Medicaid |
$2,212.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,085.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,107.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,461.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,461.36
|
| Rate for Payer: UHC Medicaid |
$2,107.00
|
| Rate for Payer: UHCCP Medicaid |
$2,107.00
|
|
|
PR RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT
|
Professional
|
Both
|
$2,042.00
|
|
|
Service Code
|
HCPCS 26540
|
| Min. Negotiated Rate |
$433.24 |
| Max. Negotiated Rate |
$1,531.50 |
| Rate for Payer: Aetna Commercial |
$924.08
|
| Rate for Payer: Aetna Medicare |
$1,021.00
|
| Rate for Payer: BCBS Complete |
$454.90
|
| Rate for Payer: BCN Commercial |
$1,057.21
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Mclaren Medicaid |
$433.24
|
| Rate for Payer: Meridian Medicaid |
$454.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,531.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,130.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,130.14
|
| Rate for Payer: UHC Medicaid |
$433.24
|
| Rate for Payer: UHCCP Medicaid |
$433.24
|
|
|
PR RPR COMPONENT INFLATABLE PENILE PROSTHESIS
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 54408
|
| Min. Negotiated Rate |
$457.95 |
| Max. Negotiated Rate |
$1,292.69 |
| Rate for Payer: Aetna Commercial |
$1,014.50
|
| Rate for Payer: Aetna Medicare |
$775.00
|
| Rate for Payer: BCBS Complete |
$480.85
|
| Rate for Payer: BCN Commercial |
$1,186.69
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Mclaren Medicaid |
$457.95
|
| Rate for Payer: Meridian Medicaid |
$480.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,162.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,292.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,292.69
|
| Rate for Payer: UHC Medicaid |
$457.95
|
| Rate for Payer: UHCCP Medicaid |
$457.95
|
|
|
PR RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS
|
Professional
|
Both
|
$5,983.00
|
|
|
Service Code
|
HCPCS 33500
|
| Min. Negotiated Rate |
$948.92 |
| Max. Negotiated Rate |
$4,487.25 |
| Rate for Payer: Aetna Commercial |
$2,094.69
|
| Rate for Payer: Aetna Medicare |
$2,991.50
|
| Rate for Payer: BCBS Complete |
$996.37
|
| Rate for Payer: BCN Commercial |
$2,294.20
|
| Rate for Payer: Cash Price |
$4,786.40
|
| Rate for Payer: Cash Price |
$4,786.40
|
| Rate for Payer: Mclaren Medicaid |
$948.92
|
| Rate for Payer: Meridian Medicaid |
$996.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,487.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$948.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,467.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,467.11
|
| Rate for Payer: UHC Medicaid |
$948.92
|
| Rate for Payer: UHCCP Medicaid |
$948.92
|
|
|
PR RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT
|
Professional
|
Both
|
$878.00
|
|
|
Service Code
|
HCPCS 36576
|
| Min. Negotiated Rate |
$108.84 |
| Max. Negotiated Rate |
$658.50 |
| Rate for Payer: Aetna Commercial |
$245.57
|
| Rate for Payer: Aetna Medicare |
$439.00
|
| Rate for Payer: BCBS Complete |
$114.28
|
| Rate for Payer: BCN Commercial |
$270.90
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Mclaren Medicaid |
$108.84
|
| Rate for Payer: Meridian Medicaid |
$114.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$658.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$291.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.31
|
| Rate for Payer: UHC Medicaid |
$108.84
|
| Rate for Payer: UHCCP Medicaid |
$108.84
|
|
|
PR RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT
|
Professional
|
Both
|
$6,173.00
|
|
|
Service Code
|
HCPCS 39540
|
| Min. Negotiated Rate |
$521.85 |
| Max. Negotiated Rate |
$4,629.75 |
| Rate for Payer: Aetna Commercial |
$887.30
|
| Rate for Payer: Aetna Medicare |
$3,086.50
|
| Rate for Payer: BCBS Complete |
$547.94
|
| Rate for Payer: BCN Commercial |
$1,290.77
|
| Rate for Payer: Cash Price |
$4,938.40
|
| Rate for Payer: Cash Price |
$4,938.40
|
| Rate for Payer: Mclaren Medicaid |
$521.85
|
| Rate for Payer: Meridian Medicaid |
$547.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,629.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,388.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,388.05
|
| Rate for Payer: UHC Medicaid |
$521.85
|
| Rate for Payer: UHCCP Medicaid |
$521.85
|
|
|
PR RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC
|
Professional
|
Both
|
$1,763.00
|
|
|
Service Code
|
HCPCS 39541
|
| Min. Negotiated Rate |
$566.37 |
| Max. Negotiated Rate |
$1,507.47 |
| Rate for Payer: Aetna Commercial |
$964.34
|
| Rate for Payer: Aetna Medicare |
$881.50
|
| Rate for Payer: BCBS Complete |
$594.69
|
| Rate for Payer: BCN Commercial |
$1,401.82
|
| Rate for Payer: Cash Price |
$1,410.40
|
| Rate for Payer: Cash Price |
$1,410.40
|
| Rate for Payer: Mclaren Medicaid |
$566.37
|
| Rate for Payer: Meridian Medicaid |
$594.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,322.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,507.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,507.47
|
| Rate for Payer: UHC Medicaid |
$566.37
|
| Rate for Payer: UHCCP Medicaid |
$566.37
|
|
|
PR RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS 27675
|
| Min. Negotiated Rate |
$299.27 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Aetna Commercial |
$654.05
|
| Rate for Payer: Aetna Medicare |
$670.00
|
| Rate for Payer: BCBS Complete |
$314.23
|
| Rate for Payer: BCN Commercial |
$756.93
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Mclaren Medicaid |
$299.27
|
| Rate for Payer: Meridian Medicaid |
$314.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$809.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$809.14
|
| Rate for Payer: UHC Medicaid |
$299.27
|
| Rate for Payer: UHCCP Medicaid |
$299.27
|
|
|
PR RPR DURAL/CEREBROSPINAL FLUID LEAK X REQ LAM
|
Professional
|
Both
|
$1,986.00
|
|
|
Service Code
|
HCPCS 63707
|
| Min. Negotiated Rate |
$591.71 |
| Max. Negotiated Rate |
$1,678.51 |
| Rate for Payer: Aetna Commercial |
$1,204.37
|
| Rate for Payer: Aetna Medicare |
$993.00
|
| Rate for Payer: BCBS Complete |
$621.30
|
| Rate for Payer: BCN Commercial |
$1,587.59
|
| Rate for Payer: Cash Price |
$1,588.80
|
| Rate for Payer: Cash Price |
$1,588.80
|
| Rate for Payer: Mclaren Medicaid |
$591.71
|
| Rate for Payer: Meridian Medicaid |
$621.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,489.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,678.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,678.51
|
| Rate for Payer: UHC Medicaid |
$591.71
|
| Rate for Payer: UHCCP Medicaid |
$591.71
|
|
|
PR RPR DURAL/CSF LEAK/PSEUDOMENINGOCELE W/LAM
|
Professional
|
Both
|
$6,209.00
|
|
|
Service Code
|
HCPCS 63709
|
| Min. Negotiated Rate |
$691.82 |
| Max. Negotiated Rate |
$4,656.75 |
| Rate for Payer: Aetna Commercial |
$1,435.43
|
| Rate for Payer: Aetna Medicare |
$3,104.50
|
| Rate for Payer: BCBS Complete |
$726.41
|
| Rate for Payer: BCN Commercial |
$1,866.05
|
| Rate for Payer: Cash Price |
$4,967.20
|
| Rate for Payer: Cash Price |
$4,967.20
|
| Rate for Payer: Mclaren Medicaid |
$691.82
|
| Rate for Payer: Meridian Medicaid |
$726.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,656.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,972.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,972.91
|
| Rate for Payer: UHC Medicaid |
$691.82
|
| Rate for Payer: UHCCP Medicaid |
$691.82
|
|
|
PR RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY
|
Professional
|
Both
|
$6,019.00
|
|
|
Service Code
|
HCPCS 62120
|
| Min. Negotiated Rate |
$1,367.67 |
| Max. Negotiated Rate |
$4,514.25 |
| Rate for Payer: Aetna Commercial |
$2,715.90
|
| Rate for Payer: Aetna Medicare |
$3,009.50
|
| Rate for Payer: BCBS Complete |
$1,436.05
|
| Rate for Payer: BCN Commercial |
$3,146.25
|
| Rate for Payer: Cash Price |
$4,815.20
|
| Rate for Payer: Cash Price |
$4,815.20
|
| Rate for Payer: Mclaren Medicaid |
$1,367.67
|
| Rate for Payer: Meridian Medicaid |
$1,436.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,514.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,367.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,654.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,654.30
|
| Rate for Payer: UHC Medicaid |
$1,367.67
|
| Rate for Payer: UHCCP Medicaid |
$1,367.67
|
|
|
PR RPR EPIGASTRIC HERNIA INCARCERATED
|
Professional
|
Both
|
$1,533.00
|
|
|
Service Code
|
HCPCS 49572
|
| Min. Negotiated Rate |
$613.20 |
| Max. Negotiated Rate |
$1,149.75 |
| Rate for Payer: Aetna Medicare |
$766.50
|
| Rate for Payer: BCBS Complete |
$613.20
|
| Rate for Payer: Cash Price |
$1,226.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,149.75
|
|
|
PR RPR EPIGASTRIC HERNIA REDUCIBLE SPX
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
HCPCS 49570
|
| Min. Negotiated Rate |
$482.40 |
| Max. Negotiated Rate |
$904.50 |
| Rate for Payer: Aetna Medicare |
$603.00
|
| Rate for Payer: BCBS Complete |
$482.40
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$904.50
|
|
|
PR RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH
|
Professional
|
Both
|
$625.00
|
|
|
Service Code
|
HCPCS 27664
|
| Min. Negotiated Rate |
$219.39 |
| Max. Negotiated Rate |
$583.44 |
| Rate for Payer: Aetna Commercial |
$480.09
|
| Rate for Payer: Aetna Medicare |
$312.50
|
| Rate for Payer: BCBS Complete |
$230.36
|
| Rate for Payer: BCN Commercial |
$545.79
|
| Rate for Payer: Cash Price |
$500.00
|
| Rate for Payer: Cash Price |
$500.00
|
| Rate for Payer: Mclaren Medicaid |
$219.39
|
| Rate for Payer: Meridian Medicaid |
$230.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$583.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.44
|
| Rate for Payer: UHC Medicaid |
$219.39
|
| Rate for Payer: UHCCP Medicaid |
$219.39
|
|
|
PR RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH
|
Professional
|
Both
|
$885.00
|
|
|
Service Code
|
HCPCS 27665
|
| Min. Negotiated Rate |
$254.75 |
| Max. Negotiated Rate |
$680.32 |
| Rate for Payer: Aetna Commercial |
$558.66
|
| Rate for Payer: Aetna Medicare |
$442.50
|
| Rate for Payer: BCBS Complete |
$267.49
|
| Rate for Payer: BCN Commercial |
$636.42
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Mclaren Medicaid |
$254.75
|
| Rate for Payer: Meridian Medicaid |
$267.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$680.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$680.32
|
| Rate for Payer: UHC Medicaid |
$254.75
|
| Rate for Payer: UHCCP Medicaid |
$254.75
|
|
|
PR RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH
|
Professional
|
Both
|
$1,121.00
|
|
|
Service Code
|
HCPCS 27659
|
| Min. Negotiated Rate |
$284.78 |
| Max. Negotiated Rate |
$840.75 |
| Rate for Payer: Aetna Commercial |
$625.38
|
| Rate for Payer: Aetna Medicare |
$560.50
|
| Rate for Payer: BCBS Complete |
$299.02
|
| Rate for Payer: BCN Commercial |
$719.08
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Mclaren Medicaid |
$284.78
|
| Rate for Payer: Meridian Medicaid |
$299.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$840.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$768.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$768.68
|
| Rate for Payer: UHC Medicaid |
$284.78
|
| Rate for Payer: UHCCP Medicaid |
$284.78
|
|
|
PR RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR
|
Professional
|
Both
|
$5,724.00
|
|
|
Service Code
|
HCPCS 46740
|
| Min. Negotiated Rate |
$1,321.45 |
| Max. Negotiated Rate |
$4,293.00 |
| Rate for Payer: Aetna Commercial |
$2,917.67
|
| Rate for Payer: Aetna Medicare |
$2,862.00
|
| Rate for Payer: BCBS Complete |
$1,387.52
|
| Rate for Payer: BCN Commercial |
$3,269.25
|
| Rate for Payer: Cash Price |
$4,579.20
|
| Rate for Payer: Cash Price |
$4,579.20
|
| Rate for Payer: Mclaren Medicaid |
$1,321.45
|
| Rate for Payer: Meridian Medicaid |
$1,387.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,293.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,321.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,983.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,983.37
|
| Rate for Payer: UHC Medicaid |
$1,321.45
|
| Rate for Payer: UHCCP Medicaid |
$1,321.45
|
|
|
PR RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL
|
Professional
|
Both
|
$5,301.00
|
|
|
Service Code
|
HCPCS 46742
|
| Min. Negotiated Rate |
$1,514.43 |
| Max. Negotiated Rate |
$4,591.93 |
| Rate for Payer: Aetna Commercial |
$3,377.01
|
| Rate for Payer: Aetna Medicare |
$2,650.50
|
| Rate for Payer: BCBS Complete |
$1,590.15
|
| Rate for Payer: BCN Commercial |
$3,768.72
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Mclaren Medicaid |
$1,514.43
|
| Rate for Payer: Meridian Medicaid |
$1,590.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,975.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,514.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,591.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,591.93
|
| Rate for Payer: UHC Medicaid |
$1,514.43
|
| Rate for Payer: UHCCP Medicaid |
$1,514.43
|
|
|
PR RPR HI IMPRF ANUS W/O FISTULA CMBN APPR
|
Professional
|
Both
|
$4,903.00
|
|
|
Service Code
|
HCPCS 46735
|
| Min. Negotiated Rate |
$1,388.33 |
| Max. Negotiated Rate |
$4,198.77 |
| Rate for Payer: Aetna Commercial |
$3,080.34
|
| Rate for Payer: Aetna Medicare |
$2,451.50
|
| Rate for Payer: BCBS Complete |
$1,457.75
|
| Rate for Payer: BCN Commercial |
$3,446.03
|
| Rate for Payer: Cash Price |
$3,922.40
|
| Rate for Payer: Cash Price |
$3,922.40
|
| Rate for Payer: Mclaren Medicaid |
$1,388.33
|
| Rate for Payer: Meridian Medicaid |
$1,457.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,677.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,388.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,198.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,198.77
|
| Rate for Payer: UHC Medicaid |
$1,388.33
|
| Rate for Payer: UHCCP Medicaid |
$1,388.33
|
|
|
PR RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR
|
Professional
|
Both
|
$3,995.00
|
|
|
Service Code
|
HCPCS 46730
|
| Min. Negotiated Rate |
$1,216.44 |
| Max. Negotiated Rate |
$3,653.90 |
| Rate for Payer: Aetna Commercial |
$2,672.39
|
| Rate for Payer: Aetna Medicare |
$1,997.50
|
| Rate for Payer: BCBS Complete |
$1,277.26
|
| Rate for Payer: BCN Commercial |
$2,998.84
|
| Rate for Payer: Cash Price |
$3,196.00
|
| Rate for Payer: Cash Price |
$3,196.00
|
| Rate for Payer: Mclaren Medicaid |
$1,216.44
|
| Rate for Payer: Meridian Medicaid |
$1,277.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,996.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,216.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,653.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,653.90
|
| Rate for Payer: UHC Medicaid |
$1,216.44
|
| Rate for Payer: UHCCP Medicaid |
$1,216.44
|
|
|
PR RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE
|
Professional
|
Both
|
$2,045.00
|
|
|
Service Code
|
HCPCS 54340
|
| Min. Negotiated Rate |
$332.07 |
| Max. Negotiated Rate |
$1,533.75 |
| Rate for Payer: Aetna Commercial |
$730.32
|
| Rate for Payer: Aetna Medicare |
$1,022.50
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCN Commercial |
$855.53
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Mclaren Medicaid |
$332.07
|
| Rate for Payer: Meridian Medicaid |
$348.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$931.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$931.95
|
| Rate for Payer: UHC Medicaid |
$332.07
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
|
