|
PR SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY
|
Professional
|
Both
|
$1,009.00
|
|
|
Service Code
|
HCPCS 36014
|
| Min. Negotiated Rate |
$144.36 |
| Max. Negotiated Rate |
$655.85 |
| Rate for Payer: Aetna Commercial |
$193.44
|
| Rate for Payer: Aetna Medicare |
$150.13
|
| Rate for Payer: BCBS Complete |
$403.60
|
| Rate for Payer: BCBS MAPPO |
$144.36
|
| Rate for Payer: BCN Medicare Advantage |
$144.36
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Cofinity Commercial |
$207.88
|
| Rate for Payer: Cofinity Commercial |
$193.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.58
|
| Rate for Payer: Nomi Health Commercial |
$173.23
|
| Rate for Payer: PACE SWMI |
$144.36
|
| Rate for Payer: PHP Medicare Advantage |
$144.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$655.85
|
| Rate for Payer: Priority Health Medicare |
$145.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.36
|
| Rate for Payer: UHC Exchange |
$144.36
|
| Rate for Payer: UHC Medicare Advantage |
$144.36
|
|
|
PR SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT
|
Professional
|
Both
|
$1,360.00
|
|
|
Service Code
|
HCPCS 36228
|
| Min. Negotiated Rate |
$244.43 |
| Max. Negotiated Rate |
$884.00 |
| Rate for Payer: Aetna Commercial |
$327.54
|
| Rate for Payer: Aetna Medicare |
$254.21
|
| Rate for Payer: BCBS Complete |
$544.00
|
| Rate for Payer: BCBS MAPPO |
$244.43
|
| Rate for Payer: BCN Medicare Advantage |
$244.43
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Cofinity Commercial |
$351.98
|
| Rate for Payer: Cofinity Commercial |
$327.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.65
|
| Rate for Payer: Nomi Health Commercial |
$293.32
|
| Rate for Payer: PACE SWMI |
$244.43
|
| Rate for Payer: PHP Medicare Advantage |
$244.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.00
|
| Rate for Payer: Priority Health Medicare |
$246.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$244.43
|
| Rate for Payer: UHC Exchange |
$244.43
|
| Rate for Payer: UHC Medicare Advantage |
$244.43
|
|
|
PR SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART
|
Professional
|
Both
|
$1,258.00
|
|
|
Service Code
|
HCPCS 36224
|
| Min. Negotiated Rate |
$359.67 |
| Max. Negotiated Rate |
$817.70 |
| Rate for Payer: Aetna Commercial |
$481.96
|
| Rate for Payer: Aetna Medicare |
$374.06
|
| Rate for Payer: BCBS Complete |
$503.20
|
| Rate for Payer: BCBS MAPPO |
$359.67
|
| Rate for Payer: BCN Medicare Advantage |
$359.67
|
| Rate for Payer: Cash Price |
$1,006.40
|
| Rate for Payer: Cash Price |
$1,006.40
|
| Rate for Payer: Cofinity Commercial |
$517.92
|
| Rate for Payer: Cofinity Commercial |
$481.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.65
|
| Rate for Payer: Nomi Health Commercial |
$431.60
|
| Rate for Payer: PACE SWMI |
$359.67
|
| Rate for Payer: PHP Medicare Advantage |
$359.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.70
|
| Rate for Payer: Priority Health Medicare |
$363.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$359.67
|
| Rate for Payer: UHC Exchange |
$359.67
|
| Rate for Payer: UHC Medicare Advantage |
$359.67
|
|
|
PR SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$2,344.00
|
|
|
Service Code
|
HCPCS 36216
|
| Min. Negotiated Rate |
$260.65 |
| Max. Negotiated Rate |
$1,523.60 |
| Rate for Payer: Aetna Commercial |
$349.27
|
| Rate for Payer: Aetna Medicare |
$271.08
|
| Rate for Payer: BCBS Complete |
$937.60
|
| Rate for Payer: BCBS MAPPO |
$260.65
|
| Rate for Payer: BCN Medicare Advantage |
$260.65
|
| Rate for Payer: Cash Price |
$1,875.20
|
| Rate for Payer: Cash Price |
$1,875.20
|
| Rate for Payer: Cofinity Commercial |
$375.34
|
| Rate for Payer: Cofinity Commercial |
$349.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.68
|
| Rate for Payer: Nomi Health Commercial |
$312.78
|
| Rate for Payer: PACE SWMI |
$260.65
|
| Rate for Payer: PHP Medicare Advantage |
$260.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,523.60
|
| Rate for Payer: Priority Health Medicare |
$263.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.65
|
| Rate for Payer: UHC Exchange |
$260.65
|
| Rate for Payer: UHC Medicare Advantage |
$260.65
|
|
|
PR SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$1,042.00
|
|
|
Service Code
|
HCPCS 36246
|
| Min. Negotiated Rate |
$240.57 |
| Max. Negotiated Rate |
$677.30 |
| Rate for Payer: Aetna Commercial |
$322.36
|
| Rate for Payer: Aetna Medicare |
$250.19
|
| Rate for Payer: BCBS Complete |
$416.80
|
| Rate for Payer: BCBS MAPPO |
$240.57
|
| Rate for Payer: BCN Medicare Advantage |
$240.57
|
| Rate for Payer: Cash Price |
$833.60
|
| Rate for Payer: Cash Price |
$833.60
|
| Rate for Payer: Cofinity Commercial |
$346.42
|
| Rate for Payer: Cofinity Commercial |
$322.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.60
|
| Rate for Payer: Nomi Health Commercial |
$288.68
|
| Rate for Payer: PACE SWMI |
$240.57
|
| Rate for Payer: PHP Medicare Advantage |
$240.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.30
|
| Rate for Payer: Priority Health Medicare |
$242.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.57
|
| Rate for Payer: UHC Exchange |
$240.57
|
| Rate for Payer: UHC Medicare Advantage |
$240.57
|
|
|
PR SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH
|
Professional
|
Both
|
$1,304.00
|
|
|
Service Code
|
HCPCS 36247
|
| Min. Negotiated Rate |
$282.44 |
| Max. Negotiated Rate |
$847.60 |
| Rate for Payer: Aetna Commercial |
$378.47
|
| Rate for Payer: Aetna Medicare |
$293.74
|
| Rate for Payer: BCBS Complete |
$521.60
|
| Rate for Payer: BCBS MAPPO |
$282.44
|
| Rate for Payer: BCN Medicare Advantage |
$282.44
|
| Rate for Payer: Cash Price |
$1,043.20
|
| Rate for Payer: Cash Price |
$1,043.20
|
| Rate for Payer: Cofinity Commercial |
$406.71
|
| Rate for Payer: Cofinity Commercial |
$378.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.56
|
| Rate for Payer: Nomi Health Commercial |
$338.93
|
| Rate for Payer: PACE SWMI |
$282.44
|
| Rate for Payer: PHP Medicare Advantage |
$282.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.60
|
| Rate for Payer: Priority Health Medicare |
$285.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.44
|
| Rate for Payer: UHC Exchange |
$282.44
|
| Rate for Payer: UHC Medicare Advantage |
$282.44
|
|
|
PR SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$1,377.00
|
|
|
Service Code
|
HCPCS 36217
|
| Min. Negotiated Rate |
$324.61 |
| Max. Negotiated Rate |
$895.05 |
| Rate for Payer: Aetna Commercial |
$434.98
|
| Rate for Payer: Aetna Medicare |
$337.59
|
| Rate for Payer: BCBS Complete |
$550.80
|
| Rate for Payer: BCBS MAPPO |
$324.61
|
| Rate for Payer: BCN Medicare Advantage |
$324.61
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$467.44
|
| Rate for Payer: Cofinity Commercial |
$434.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.84
|
| Rate for Payer: Nomi Health Commercial |
$389.53
|
| Rate for Payer: PACE SWMI |
$324.61
|
| Rate for Payer: PHP Medicare Advantage |
$324.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health Medicare |
$327.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.61
|
| Rate for Payer: UHC Exchange |
$324.61
|
| Rate for Payer: UHC Medicare Advantage |
$324.61
|
|
|
PR SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$835.00
|
|
|
Service Code
|
HCPCS 36245
|
| Min. Negotiated Rate |
$224.63 |
| Max. Negotiated Rate |
$542.75 |
| Rate for Payer: Aetna Commercial |
$301.00
|
| Rate for Payer: Aetna Medicare |
$233.62
|
| Rate for Payer: BCBS Complete |
$334.00
|
| Rate for Payer: BCBS MAPPO |
$224.63
|
| Rate for Payer: BCN Medicare Advantage |
$224.63
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cofinity Commercial |
$323.47
|
| Rate for Payer: Cofinity Commercial |
$301.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.86
|
| Rate for Payer: Nomi Health Commercial |
$269.56
|
| Rate for Payer: PACE SWMI |
$224.63
|
| Rate for Payer: PHP Medicare Advantage |
$224.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.75
|
| Rate for Payer: Priority Health Medicare |
$226.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$224.63
|
| Rate for Payer: UHC Exchange |
$224.63
|
| Rate for Payer: UHC Medicare Advantage |
$224.63
|
|
|
PR SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 36215
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$271.22
|
| Rate for Payer: Aetna Medicare |
$210.50
|
| Rate for Payer: BCBS Complete |
$367.20
|
| Rate for Payer: BCBS MAPPO |
$202.40
|
| Rate for Payer: BCN Medicare Advantage |
$202.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cofinity Commercial |
$291.46
|
| Rate for Payer: Cofinity Commercial |
$271.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$212.52
|
| Rate for Payer: Nomi Health Commercial |
$242.88
|
| Rate for Payer: PACE SWMI |
$202.40
|
| Rate for Payer: PHP Medicare Advantage |
$202.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health Medicare |
$204.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.40
|
| Rate for Payer: UHC Exchange |
$202.40
|
| Rate for Payer: UHC Medicare Advantage |
$202.40
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 36248
|
| Min. Negotiated Rate |
$45.85 |
| Max. Negotiated Rate |
$157.95 |
| Rate for Payer: Aetna Commercial |
$61.44
|
| Rate for Payer: Aetna Medicare |
$47.68
|
| Rate for Payer: BCBS Complete |
$97.20
|
| Rate for Payer: BCBS MAPPO |
$45.85
|
| Rate for Payer: BCN Medicare Advantage |
$45.85
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cofinity Commercial |
$66.02
|
| Rate for Payer: Cofinity Commercial |
$61.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.14
|
| Rate for Payer: Nomi Health Commercial |
$55.02
|
| Rate for Payer: PACE SWMI |
$45.85
|
| Rate for Payer: PHP Medicare Advantage |
$45.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.95
|
| Rate for Payer: Priority Health Medicare |
$46.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.85
|
| Rate for Payer: UHC Exchange |
$45.85
|
| Rate for Payer: UHC Medicare Advantage |
$45.85
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 36218
|
| Min. Negotiated Rate |
$50.36 |
| Max. Negotiated Rate |
$213.20 |
| Rate for Payer: Aetna Commercial |
$67.48
|
| Rate for Payer: Aetna Medicare |
$52.37
|
| Rate for Payer: BCBS Complete |
$131.20
|
| Rate for Payer: BCBS MAPPO |
$50.36
|
| Rate for Payer: BCN Medicare Advantage |
$50.36
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$72.52
|
| Rate for Payer: Cofinity Commercial |
$67.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.88
|
| Rate for Payer: Nomi Health Commercial |
$60.43
|
| Rate for Payer: PACE SWMI |
$50.36
|
| Rate for Payer: PHP Medicare Advantage |
$50.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health Medicare |
$50.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.36
|
| Rate for Payer: UHC Exchange |
$50.36
|
| Rate for Payer: UHC Medicare Advantage |
$50.36
|
|
|
PR SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 36015
|
| Min. Negotiated Rate |
$163.57 |
| Max. Negotiated Rate |
$621.40 |
| Rate for Payer: Aetna Commercial |
$219.18
|
| Rate for Payer: Aetna Medicare |
$170.11
|
| Rate for Payer: BCBS Complete |
$382.40
|
| Rate for Payer: BCBS MAPPO |
$163.57
|
| Rate for Payer: BCN Medicare Advantage |
$163.57
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cofinity Commercial |
$235.54
|
| Rate for Payer: Cofinity Commercial |
$219.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.75
|
| Rate for Payer: Nomi Health Commercial |
$196.28
|
| Rate for Payer: PACE SWMI |
$163.57
|
| Rate for Payer: PHP Medicare Advantage |
$163.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$621.40
|
| Rate for Payer: Priority Health Medicare |
$165.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.57
|
| Rate for Payer: UHC Exchange |
$163.57
|
| Rate for Payer: UHC Medicare Advantage |
$163.57
|
|
|
PR SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 36011
|
| Min. Negotiated Rate |
$148.41 |
| Max. Negotiated Rate |
$485.55 |
| Rate for Payer: Aetna Commercial |
$198.87
|
| Rate for Payer: Aetna Medicare |
$154.35
|
| Rate for Payer: BCBS Complete |
$298.80
|
| Rate for Payer: BCBS MAPPO |
$148.41
|
| Rate for Payer: BCN Medicare Advantage |
$148.41
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cofinity Commercial |
$213.71
|
| Rate for Payer: Cofinity Commercial |
$198.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.83
|
| Rate for Payer: Nomi Health Commercial |
$178.09
|
| Rate for Payer: PACE SWMI |
$148.41
|
| Rate for Payer: PHP Medicare Advantage |
$148.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.55
|
| Rate for Payer: Priority Health Medicare |
$149.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.41
|
| Rate for Payer: UHC Exchange |
$148.41
|
| Rate for Payer: UHC Medicare Advantage |
$148.41
|
|
|
PR SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC
|
Professional
|
Both
|
$980.00
|
|
|
Service Code
|
HCPCS 36012
|
| Min. Negotiated Rate |
$166.65 |
| Max. Negotiated Rate |
$637.00 |
| Rate for Payer: Aetna Commercial |
$223.31
|
| Rate for Payer: Aetna Medicare |
$173.32
|
| Rate for Payer: BCBS Complete |
$392.00
|
| Rate for Payer: BCBS MAPPO |
$166.65
|
| Rate for Payer: BCN Medicare Advantage |
$166.65
|
| Rate for Payer: Cash Price |
$784.00
|
| Rate for Payer: Cash Price |
$784.00
|
| Rate for Payer: Cofinity Commercial |
$239.98
|
| Rate for Payer: Cofinity Commercial |
$223.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.98
|
| Rate for Payer: Nomi Health Commercial |
$199.98
|
| Rate for Payer: PACE SWMI |
$166.65
|
| Rate for Payer: PHP Medicare Advantage |
$166.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.00
|
| Rate for Payer: Priority Health Medicare |
$168.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.65
|
| Rate for Payer: UHC Exchange |
$166.65
|
| Rate for Payer: UHC Medicare Advantage |
$166.65
|
|
|
PR SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,788.00
|
|
|
Service Code
|
HCPCS 36225
|
| Min. Negotiated Rate |
$318.61 |
| Max. Negotiated Rate |
$1,162.20 |
| Rate for Payer: Aetna Commercial |
$426.94
|
| Rate for Payer: Aetna Medicare |
$331.35
|
| Rate for Payer: BCBS Complete |
$715.20
|
| Rate for Payer: BCBS MAPPO |
$318.61
|
| Rate for Payer: BCN Medicare Advantage |
$318.61
|
| Rate for Payer: Cash Price |
$1,430.40
|
| Rate for Payer: Cash Price |
$1,430.40
|
| Rate for Payer: Cofinity Commercial |
$458.80
|
| Rate for Payer: Cofinity Commercial |
$426.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.54
|
| Rate for Payer: Nomi Health Commercial |
$382.33
|
| Rate for Payer: PACE SWMI |
$318.61
|
| Rate for Payer: PHP Medicare Advantage |
$318.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.20
|
| Rate for Payer: Priority Health Medicare |
$321.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.61
|
| Rate for Payer: UHC Exchange |
$318.61
|
| Rate for Payer: UHC Medicare Advantage |
$318.61
|
|
|
PR SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 36226
|
| Min. Negotiated Rate |
$357.06 |
| Max. Negotiated Rate |
$819.00 |
| Rate for Payer: Aetna Commercial |
$478.46
|
| Rate for Payer: Aetna Medicare |
$371.34
|
| Rate for Payer: BCBS Complete |
$504.00
|
| Rate for Payer: BCBS MAPPO |
$357.06
|
| Rate for Payer: BCN Medicare Advantage |
$357.06
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cofinity Commercial |
$514.17
|
| Rate for Payer: Cofinity Commercial |
$478.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.91
|
| Rate for Payer: Nomi Health Commercial |
$428.47
|
| Rate for Payer: PACE SWMI |
$357.06
|
| Rate for Payer: PHP Medicare Advantage |
$357.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health Medicare |
$360.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.06
|
| Rate for Payer: UHC Exchange |
$357.06
|
| Rate for Payer: UHC Medicare Advantage |
$357.06
|
|
|
PR SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 36227
|
| Min. Negotiated Rate |
$117.73 |
| Max. Negotiated Rate |
$258.70 |
| Rate for Payer: Aetna Commercial |
$157.76
|
| Rate for Payer: Aetna Medicare |
$122.44
|
| Rate for Payer: BCBS Complete |
$159.20
|
| Rate for Payer: BCBS MAPPO |
$117.73
|
| Rate for Payer: BCN Medicare Advantage |
$117.73
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$169.53
|
| Rate for Payer: Cofinity Commercial |
$157.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.62
|
| Rate for Payer: Nomi Health Commercial |
$141.28
|
| Rate for Payer: PACE SWMI |
$117.73
|
| Rate for Payer: PHP Medicare Advantage |
$117.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.70
|
| Rate for Payer: Priority Health Medicare |
$118.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.73
|
| Rate for Payer: UHC Exchange |
$117.73
|
| Rate for Payer: UHC Medicare Advantage |
$117.73
|
|
|
PR SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT
|
Professional
|
Both
|
$567.00
|
|
|
Service Code
|
HCPCS 95806
|
| Min. Negotiated Rate |
$87.97 |
| Max. Negotiated Rate |
$368.55 |
| Rate for Payer: Aetna Commercial |
$117.88
|
| Rate for Payer: Aetna Commercial |
$117.88
|
| Rate for Payer: Aetna Medicare |
$91.49
|
| Rate for Payer: Aetna Medicare |
$91.49
|
| Rate for Payer: BCBS Complete |
$226.80
|
| Rate for Payer: BCBS Complete |
$59.60
|
| Rate for Payer: BCBS MAPPO |
$87.97
|
| Rate for Payer: BCBS MAPPO |
$87.97
|
| Rate for Payer: BCN Medicare Advantage |
$87.97
|
| Rate for Payer: BCN Medicare Advantage |
$87.97
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cofinity Commercial |
$126.68
|
| Rate for Payer: Cofinity Commercial |
$126.68
|
| Rate for Payer: Cofinity Commercial |
$117.88
|
| Rate for Payer: Cofinity Commercial |
$117.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.37
|
| Rate for Payer: Nomi Health Commercial |
$105.56
|
| Rate for Payer: Nomi Health Commercial |
$105.56
|
| Rate for Payer: PACE SWMI |
$87.97
|
| Rate for Payer: PACE SWMI |
$87.97
|
| Rate for Payer: PHP Medicare Advantage |
$87.97
|
| Rate for Payer: PHP Medicare Advantage |
$87.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.55
|
| Rate for Payer: Priority Health Medicare |
$88.85
|
| Rate for Payer: Priority Health Medicare |
$88.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.97
|
| Rate for Payer: UHC Exchange |
$87.97
|
| Rate for Payer: UHC Exchange |
$87.97
|
| Rate for Payer: UHC Medicare Advantage |
$87.97
|
| Rate for Payer: UHC Medicare Advantage |
$87.97
|
|
|
PR SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 95807
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$534.28 |
| Rate for Payer: Aetna Commercial |
$497.18
|
| Rate for Payer: Aetna Commercial |
$497.18
|
| Rate for Payer: Aetna Medicare |
$385.87
|
| Rate for Payer: Aetna Medicare |
$385.87
|
| Rate for Payer: BCBS Complete |
$59.20
|
| Rate for Payer: BCBS Complete |
$595.60
|
| Rate for Payer: BCBS MAPPO |
$371.03
|
| Rate for Payer: BCBS MAPPO |
$371.03
|
| Rate for Payer: BCN Medicare Advantage |
$371.03
|
| Rate for Payer: BCN Medicare Advantage |
$371.03
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$534.28
|
| Rate for Payer: Cofinity Commercial |
$497.18
|
| Rate for Payer: Cofinity Commercial |
$534.28
|
| Rate for Payer: Cofinity Commercial |
$497.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.58
|
| Rate for Payer: Nomi Health Commercial |
$445.24
|
| Rate for Payer: Nomi Health Commercial |
$445.24
|
| Rate for Payer: PACE SWMI |
$371.03
|
| Rate for Payer: PACE SWMI |
$371.03
|
| Rate for Payer: PHP Medicare Advantage |
$371.03
|
| Rate for Payer: PHP Medicare Advantage |
$371.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$967.85
|
| Rate for Payer: Priority Health Medicare |
$374.74
|
| Rate for Payer: Priority Health Medicare |
$374.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$371.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$371.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.03
|
| Rate for Payer: UHC Exchange |
$371.03
|
| Rate for Payer: UHC Exchange |
$371.03
|
| Rate for Payer: UHC Medicare Advantage |
$371.03
|
| Rate for Payer: UHC Medicare Advantage |
$371.03
|
|
|
PR SLING OPERATION STRESS INCONTINENCE
|
Professional
|
Both
|
$2,280.00
|
|
|
Service Code
|
HCPCS 57288
|
| Min. Negotiated Rate |
$712.02 |
| Max. Negotiated Rate |
$1,482.00 |
| Rate for Payer: Aetna Commercial |
$954.11
|
| Rate for Payer: Aetna Medicare |
$740.50
|
| Rate for Payer: BCBS Complete |
$912.00
|
| Rate for Payer: BCBS MAPPO |
$712.02
|
| Rate for Payer: BCN Medicare Advantage |
$712.02
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cofinity Commercial |
$954.11
|
| Rate for Payer: Cofinity Commercial |
$1,025.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$747.62
|
| Rate for Payer: Nomi Health Commercial |
$854.42
|
| Rate for Payer: PACE SWMI |
$712.02
|
| Rate for Payer: PHP Medicare Advantage |
$712.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,482.00
|
| Rate for Payer: Priority Health Medicare |
$719.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$712.02
|
| Rate for Payer: UHC Exchange |
$712.02
|
| Rate for Payer: UHC Medicare Advantage |
$712.02
|
|
|
PR SLING OPRATION CORRJ MALE URINARY INCONTINENCE
|
Professional
|
Both
|
$1,677.00
|
|
|
Service Code
|
HCPCS 53440
|
| Min. Negotiated Rate |
$670.80 |
| Max. Negotiated Rate |
$1,090.05 |
| Rate for Payer: Aetna Commercial |
$963.79
|
| Rate for Payer: Aetna Medicare |
$748.02
|
| Rate for Payer: BCBS Complete |
$670.80
|
| Rate for Payer: BCBS MAPPO |
$719.25
|
| Rate for Payer: BCN Medicare Advantage |
$719.25
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cofinity Commercial |
$963.79
|
| Rate for Payer: Cofinity Commercial |
$1,035.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.21
|
| Rate for Payer: Nomi Health Commercial |
$863.10
|
| Rate for Payer: PACE SWMI |
$719.25
|
| Rate for Payer: PHP Medicare Advantage |
$719.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.05
|
| Rate for Payer: Priority Health Medicare |
$726.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$719.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.25
|
| Rate for Payer: UHC Exchange |
$719.25
|
| Rate for Payer: UHC Medicare Advantage |
$719.25
|
|
|
PR SLINGS
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS A4565
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$15.49 |
| Rate for Payer: Aetna Commercial |
$14.42
|
| Rate for Payer: Aetna Medicare |
$11.19
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$10.76
|
| Rate for Payer: BCN Medicare Advantage |
$10.76
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$15.49
|
| Rate for Payer: Cofinity Commercial |
$14.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.30
|
| Rate for Payer: Nomi Health Commercial |
$12.91
|
| Rate for Payer: PACE SWMI |
$10.76
|
| Rate for Payer: PHP Medicare Advantage |
$10.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: Priority Health Medicare |
$10.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.76
|
| Rate for Payer: UHC Exchange |
$10.76
|
| Rate for Payer: UHC Medicare Advantage |
$10.76
|
|
|
PR SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 54001
|
| Min. Negotiated Rate |
$134.00 |
| Max. Negotiated Rate |
$217.75 |
| Rate for Payer: Aetna Commercial |
$180.43
|
| Rate for Payer: Aetna Medicare |
$140.04
|
| Rate for Payer: BCBS Complete |
$134.00
|
| Rate for Payer: BCBS MAPPO |
$134.65
|
| Rate for Payer: BCN Medicare Advantage |
$134.65
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$193.90
|
| Rate for Payer: Cofinity Commercial |
$180.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.38
|
| Rate for Payer: Nomi Health Commercial |
$161.58
|
| Rate for Payer: PACE SWMI |
$134.65
|
| Rate for Payer: PHP Medicare Advantage |
$134.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.75
|
| Rate for Payer: Priority Health Medicare |
$136.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.65
|
| Rate for Payer: UHC Exchange |
$134.65
|
| Rate for Payer: UHC Medicare Advantage |
$134.65
|
|
|
PR SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 95800
|
| Min. Negotiated Rate |
$116.32 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Commercial |
$155.87
|
| Rate for Payer: Aetna Commercial |
$155.87
|
| Rate for Payer: Aetna Medicare |
$120.97
|
| Rate for Payer: Aetna Medicare |
$120.97
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: BCBS MAPPO |
$116.32
|
| Rate for Payer: BCBS MAPPO |
$116.32
|
| Rate for Payer: BCN Medicare Advantage |
$116.32
|
| Rate for Payer: BCN Medicare Advantage |
$116.32
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$167.50
|
| Rate for Payer: Cofinity Commercial |
$155.87
|
| Rate for Payer: Cofinity Commercial |
$167.50
|
| Rate for Payer: Cofinity Commercial |
$155.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.14
|
| Rate for Payer: Nomi Health Commercial |
$139.58
|
| Rate for Payer: Nomi Health Commercial |
$139.58
|
| Rate for Payer: PACE SWMI |
$116.32
|
| Rate for Payer: PACE SWMI |
$116.32
|
| Rate for Payer: PHP Medicare Advantage |
$116.32
|
| Rate for Payer: PHP Medicare Advantage |
$116.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health Medicare |
$117.48
|
| Rate for Payer: Priority Health Medicare |
$117.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.32
|
| Rate for Payer: UHC Exchange |
$116.32
|
| Rate for Payer: UHC Exchange |
$116.32
|
| Rate for Payer: UHC Medicare Advantage |
$116.32
|
| Rate for Payer: UHC Medicare Advantage |
$116.32
|
|
|
PR SMOKE/TOBACCO COUNSELNG 3-10
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS G0375
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
|
