|
PR TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH
|
Professional
|
Both
|
$2,746.00
|
|
|
Service Code
|
HCPCS 26485
|
| Min. Negotiated Rate |
$514.61 |
| Max. Negotiated Rate |
$2,059.50 |
| Rate for Payer: Aetna Commercial |
$1,113.10
|
| Rate for Payer: Aetna Medicare |
$1,373.00
|
| Rate for Payer: BCBS Complete |
$540.34
|
| Rate for Payer: BCN Commercial |
$1,259.89
|
| Rate for Payer: Cash Price |
$2,196.80
|
| Rate for Payer: Cash Price |
$2,196.80
|
| Rate for Payer: Mclaren Medicaid |
$514.61
|
| Rate for Payer: Meridian Medicaid |
$540.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,059.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,346.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,346.80
|
| Rate for Payer: UHC Medicaid |
$514.61
|
| Rate for Payer: UHCCP Medicaid |
$514.61
|
|
|
PR TRANSFUSION BLOOD/BLOOD COMPONENTS
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 36430
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$69.09 |
| Rate for Payer: Aetna Commercial |
$46.41
|
| Rate for Payer: Aetna Medicare |
$43.50
|
| Rate for Payer: BCN Commercial |
$64.24
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.09
|
|
|
PR TRANSFUSION INTRAUTERINE FETAL
|
Professional
|
Both
|
$1,458.00
|
|
|
Service Code
|
HCPCS 36460
|
| Min. Negotiated Rate |
$189.78 |
| Max. Negotiated Rate |
$1,093.50 |
| Rate for Payer: Aetna Commercial |
$465.17
|
| Rate for Payer: Aetna Medicare |
$729.00
|
| Rate for Payer: BCBS Complete |
$199.27
|
| Rate for Payer: BCN Commercial |
$509.43
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Mclaren Medicaid |
$189.78
|
| Rate for Payer: Meridian Medicaid |
$199.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$547.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.82
|
| Rate for Payer: UHC Medicaid |
$189.78
|
| Rate for Payer: UHCCP Medicaid |
$189.78
|
|
|
PR TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 99496
|
| Min. Negotiated Rate |
$106.07 |
| Max. Negotiated Rate |
$273.75 |
| Rate for Payer: Aetna Commercial |
$194.16
|
| Rate for Payer: Aetna Medicare |
$182.50
|
| Rate for Payer: BCBS Complete |
$111.37
|
| Rate for Payer: BCN Commercial |
$204.87
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Mclaren Medicaid |
$106.07
|
| Rate for Payer: Meridian Medicaid |
$111.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$252.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.63
|
| Rate for Payer: UHC Medicaid |
$106.07
|
| Rate for Payer: UHCCP Medicaid |
$106.07
|
|
|
PR TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 99495
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$194.25 |
| Rate for Payer: Aetna Commercial |
$142.69
|
| Rate for Payer: Aetna Medicare |
$129.50
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCN Commercial |
$150.75
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Mclaren Medicaid |
$77.96
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$185.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.89
|
| Rate for Payer: UHC Medicaid |
$77.96
|
| Rate for Payer: UHCCP Medicaid |
$77.96
|
|
|
PR TRANSLUMINAL BALLOON ANGIOP PERIPHERAL ART RSI
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 75962
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$89.25 |
| Rate for Payer: Aetna Medicare |
$59.50
|
| Rate for Payer: BCBS Complete |
$47.60
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.25
|
|
|
PR TRANSMASTOID ANTROTOMY
|
Professional
|
Both
|
$1,833.00
|
|
|
Service Code
|
HCPCS 69501
|
| Min. Negotiated Rate |
$405.34 |
| Max. Negotiated Rate |
$1,374.75 |
| Rate for Payer: Aetna Commercial |
$813.51
|
| Rate for Payer: Aetna Medicare |
$916.50
|
| Rate for Payer: BCBS Complete |
$425.61
|
| Rate for Payer: BCN Commercial |
$1,063.19
|
| Rate for Payer: Cash Price |
$1,466.40
|
| Rate for Payer: Cash Price |
$1,466.40
|
| Rate for Payer: Mclaren Medicaid |
$405.34
|
| Rate for Payer: Meridian Medicaid |
$425.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,374.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,050.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.54
|
| Rate for Payer: UHC Medicaid |
$405.34
|
| Rate for Payer: UHCCP Medicaid |
$405.34
|
|
|
PR TRANSMETACARPAL AMPUTATION RE-AMPUTATION
|
Professional
|
Both
|
$2,332.00
|
|
|
Service Code
|
HCPCS 25931
|
| Min. Negotiated Rate |
$498.85 |
| Max. Negotiated Rate |
$1,749.00 |
| Rate for Payer: Aetna Commercial |
$1,057.63
|
| Rate for Payer: Aetna Medicare |
$1,166.00
|
| Rate for Payer: BCBS Complete |
$523.79
|
| Rate for Payer: BCN Commercial |
$1,202.63
|
| Rate for Payer: Cash Price |
$1,865.60
|
| Rate for Payer: Cash Price |
$1,865.60
|
| Rate for Payer: Mclaren Medicaid |
$498.85
|
| Rate for Payer: Meridian Medicaid |
$523.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,749.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,285.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,285.57
|
| Rate for Payer: UHC Medicaid |
$498.85
|
| Rate for Payer: UHCCP Medicaid |
$498.85
|
|
|
PR TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ
|
Professional
|
Both
|
$1,099.00
|
|
|
Service Code
|
HCPCS 25929
|
| Min. Negotiated Rate |
$364.66 |
| Max. Negotiated Rate |
$983.74 |
| Rate for Payer: Aetna Commercial |
$799.06
|
| Rate for Payer: Aetna Medicare |
$549.50
|
| Rate for Payer: BCBS Complete |
$382.89
|
| Rate for Payer: BCN Commercial |
$920.26
|
| Rate for Payer: Cash Price |
$879.20
|
| Rate for Payer: Cash Price |
$879.20
|
| Rate for Payer: Mclaren Medicaid |
$364.66
|
| Rate for Payer: Meridian Medicaid |
$382.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$824.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$983.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$983.74
|
| Rate for Payer: UHC Medicaid |
$364.66
|
| Rate for Payer: UHCCP Medicaid |
$364.66
|
|
|
PR TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 33141
|
| Min. Negotiated Rate |
$76.25 |
| Max. Negotiated Rate |
$448.50 |
| Rate for Payer: Aetna Commercial |
$178.18
|
| Rate for Payer: Aetna Medicare |
$299.00
|
| Rate for Payer: BCBS Complete |
$80.06
|
| Rate for Payer: BCN Commercial |
$193.22
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Mclaren Medicaid |
$76.25
|
| Rate for Payer: Meridian Medicaid |
$80.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$448.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.77
|
| Rate for Payer: UHC Medicaid |
$76.25
|
| Rate for Payer: UHCCP Medicaid |
$76.25
|
|
|
PR TRANSORAL LOWER ESOPHAGEAL MYOTOMY
|
Professional
|
Both
|
$1,684.00
|
|
|
Service Code
|
HCPCS 43497
|
| Min. Negotiated Rate |
$458.16 |
| Max. Negotiated Rate |
$1,430.13 |
| Rate for Payer: Aetna Commercial |
$1,057.33
|
| Rate for Payer: Aetna Medicare |
$842.00
|
| Rate for Payer: BCBS Complete |
$481.07
|
| Rate for Payer: BCN Commercial |
$1,173.74
|
| Rate for Payer: Cash Price |
$1,347.20
|
| Rate for Payer: Cash Price |
$1,347.20
|
| Rate for Payer: Mclaren Medicaid |
$458.16
|
| Rate for Payer: Meridian Medicaid |
$481.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,263.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,430.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,430.13
|
| Rate for Payer: UHC Medicaid |
$458.16
|
| Rate for Payer: UHCCP Medicaid |
$458.16
|
|
|
PR TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR
|
Professional
|
Both
|
$2,548.00
|
|
|
Service Code
|
HCPCS 63057
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$1,911.00 |
| Rate for Payer: Aetna Commercial |
$415.78
|
| Rate for Payer: Aetna Medicare |
$1,274.00
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCN Commercial |
$530.11
|
| Rate for Payer: Cash Price |
$2,038.40
|
| Rate for Payer: Cash Price |
$2,038.40
|
| Rate for Payer: Mclaren Medicaid |
$183.39
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,911.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$560.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.47
|
| Rate for Payer: UHC Medicaid |
$183.39
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
|
|
PR TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR
|
Professional
|
Both
|
$7,286.00
|
|
|
Service Code
|
HCPCS 63056
|
| Min. Negotiated Rate |
$895.88 |
| Max. Negotiated Rate |
$5,464.50 |
| Rate for Payer: Aetna Commercial |
$1,927.37
|
| Rate for Payer: Aetna Medicare |
$3,643.00
|
| Rate for Payer: BCBS Complete |
$940.67
|
| Rate for Payer: BCN Commercial |
$2,479.86
|
| Rate for Payer: Cash Price |
$5,828.80
|
| Rate for Payer: Cash Price |
$5,828.80
|
| Rate for Payer: Mclaren Medicaid |
$895.88
|
| Rate for Payer: Meridian Medicaid |
$940.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,464.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$895.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,621.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,621.87
|
| Rate for Payer: UHC Medicaid |
$895.88
|
| Rate for Payer: UHCCP Medicaid |
$895.88
|
|
|
PR TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC
|
Professional
|
Both
|
$7,679.00
|
|
|
Service Code
|
HCPCS 63055
|
| Min. Negotiated Rate |
$990.45 |
| Max. Negotiated Rate |
$5,759.25 |
| Rate for Payer: Aetna Commercial |
$2,102.90
|
| Rate for Payer: Aetna Medicare |
$3,839.50
|
| Rate for Payer: BCBS Complete |
$1,039.97
|
| Rate for Payer: BCN Commercial |
$2,712.91
|
| Rate for Payer: Cash Price |
$6,143.20
|
| Rate for Payer: Cash Price |
$6,143.20
|
| Rate for Payer: Mclaren Medicaid |
$990.45
|
| Rate for Payer: Meridian Medicaid |
$1,039.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,759.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,868.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,868.26
|
| Rate for Payer: UHC Medicaid |
$990.45
|
| Rate for Payer: UHCCP Medicaid |
$990.45
|
|
|
PR TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX
|
Professional
|
Both
|
$6,886.00
|
|
|
Service Code
|
HCPCS 55874
|
| Min. Negotiated Rate |
$90.95 |
| Max. Negotiated Rate |
$5,164.50 |
| Rate for Payer: Aetna Commercial |
$210.18
|
| Rate for Payer: Aetna Medicare |
$3,443.00
|
| Rate for Payer: BCBS Complete |
$95.50
|
| Rate for Payer: BCN Commercial |
$244.51
|
| Rate for Payer: Cash Price |
$5,508.80
|
| Rate for Payer: Cash Price |
$5,508.80
|
| Rate for Payer: Mclaren Medicaid |
$90.95
|
| Rate for Payer: Meridian Medicaid |
$95.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,164.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$266.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.35
|
| Rate for Payer: UHC Medicaid |
$90.95
|
| Rate for Payer: UHCCP Medicaid |
$90.95
|
|
|
PR TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ
|
Professional
|
Both
|
$2,803.00
|
|
|
Service Code
|
HCPCS 55875
|
| Min. Negotiated Rate |
$438.57 |
| Max. Negotiated Rate |
$2,102.25 |
| Rate for Payer: Aetna Commercial |
$989.72
|
| Rate for Payer: Aetna Medicare |
$1,401.50
|
| Rate for Payer: BCBS Complete |
$460.50
|
| Rate for Payer: BCN Commercial |
$1,174.73
|
| Rate for Payer: Cash Price |
$2,242.40
|
| Rate for Payer: Cash Price |
$2,242.40
|
| Rate for Payer: Mclaren Medicaid |
$438.57
|
| Rate for Payer: Meridian Medicaid |
$460.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,102.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,279.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,279.66
|
| Rate for Payer: UHC Medicaid |
$438.57
|
| Rate for Payer: UHCCP Medicaid |
$438.57
|
|
|
PR TRANSPLANTATION TESTIS TO THIGH
|
Professional
|
Both
|
$1,463.00
|
|
|
Service Code
|
HCPCS 54680
|
| Min. Negotiated Rate |
$453.90 |
| Max. Negotiated Rate |
$1,284.56 |
| Rate for Payer: Aetna Commercial |
$1,011.30
|
| Rate for Payer: Aetna Medicare |
$731.50
|
| Rate for Payer: BCBS Complete |
$476.60
|
| Rate for Payer: BCN Commercial |
$1,179.22
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Mclaren Medicaid |
$453.90
|
| Rate for Payer: Meridian Medicaid |
$476.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,097.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,284.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,284.56
|
| Rate for Payer: UHC Medicaid |
$453.90
|
| Rate for Payer: UHCCP Medicaid |
$453.90
|
|
|
PR TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN
|
Professional
|
Both
|
$1,936.00
|
|
|
Service Code
|
HCPCS 27397
|
| Min. Negotiated Rate |
$546.13 |
| Max. Negotiated Rate |
$1,492.11 |
| Rate for Payer: Aetna Commercial |
$1,220.27
|
| Rate for Payer: Aetna Medicare |
$968.00
|
| Rate for Payer: BCBS Complete |
$573.44
|
| Rate for Payer: BCN Commercial |
$1,395.84
|
| Rate for Payer: Cash Price |
$1,548.80
|
| Rate for Payer: Cash Price |
$1,548.80
|
| Rate for Payer: Mclaren Medicaid |
$546.13
|
| Rate for Payer: Meridian Medicaid |
$573.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,452.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,492.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,492.11
|
| Rate for Payer: UHC Medicaid |
$546.13
|
| Rate for Payer: UHCCP Medicaid |
$546.13
|
|
|
PR TRANSPOSITION OVARY
|
Professional
|
Both
|
$1,507.00
|
|
|
Service Code
|
HCPCS 58825
|
| Min. Negotiated Rate |
$400.23 |
| Max. Negotiated Rate |
$1,130.25 |
| Rate for Payer: Aetna Commercial |
$848.39
|
| Rate for Payer: Aetna Medicare |
$753.50
|
| Rate for Payer: BCBS Complete |
$420.24
|
| Rate for Payer: BCN Commercial |
$1,063.68
|
| Rate for Payer: Cash Price |
$1,205.60
|
| Rate for Payer: Cash Price |
$1,205.60
|
| Rate for Payer: Mclaren Medicaid |
$400.23
|
| Rate for Payer: Meridian Medicaid |
$420.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,130.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,077.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,077.28
|
| Rate for Payer: UHC Medicaid |
$400.23
|
| Rate for Payer: UHCCP Medicaid |
$400.23
|
|
|
PR TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM
|
Professional
|
Both
|
$5,231.00
|
|
|
Service Code
|
HCPCS 61598
|
| Min. Negotiated Rate |
$1,816.04 |
| Max. Negotiated Rate |
$5,000.81 |
| Rate for Payer: Aetna Commercial |
$3,710.93
|
| Rate for Payer: Aetna Medicare |
$2,615.50
|
| Rate for Payer: BCBS Complete |
$1,906.84
|
| Rate for Payer: BCN Commercial |
$4,305.54
|
| Rate for Payer: Cash Price |
$4,184.80
|
| Rate for Payer: Cash Price |
$4,184.80
|
| Rate for Payer: Mclaren Medicaid |
$1,816.04
|
| Rate for Payer: Meridian Medicaid |
$1,906.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,923.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,816.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,000.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,000.81
|
| Rate for Payer: UHC Medicaid |
$1,816.04
|
| Rate for Payer: UHCCP Medicaid |
$1,816.04
|
|
|
PR TRANSRECTAL DRAINAGE OF PELVIC ABSCESS
|
Professional
|
Both
|
$843.00
|
|
|
Service Code
|
HCPCS 45000
|
| Min. Negotiated Rate |
$263.27 |
| Max. Negotiated Rate |
$789.40 |
| Rate for Payer: Aetna Commercial |
$567.64
|
| Rate for Payer: Aetna Medicare |
$421.50
|
| Rate for Payer: BCBS Complete |
$276.43
|
| Rate for Payer: BCN Commercial |
$647.87
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Mclaren Medicaid |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$276.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$789.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$789.40
|
| Rate for Payer: UHC Medicaid |
$263.27
|
| Rate for Payer: UHCCP Medicaid |
$263.27
|
|
|
PR TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL
|
Professional
|
Both
|
$186.00
|
|
|
Service Code
|
HCPCS 93293
|
| Min. Negotiated Rate |
$58.69 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Aetna Commercial |
$64.88
|
| Rate for Payer: Aetna Medicare |
$93.00
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.69
|
|
|
PR TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV
|
Professional
|
Both
|
$6,436.00
|
|
|
Service Code
|
HCPCS 61595
|
| Min. Negotiated Rate |
$1,394.09 |
| Max. Negotiated Rate |
$4,827.00 |
| Rate for Payer: Aetna Commercial |
$3,082.40
|
| Rate for Payer: Aetna Medicare |
$3,218.00
|
| Rate for Payer: BCBS Complete |
$1,463.79
|
| Rate for Payer: BCN Commercial |
$3,589.94
|
| Rate for Payer: Cash Price |
$5,148.80
|
| Rate for Payer: Cash Price |
$5,148.80
|
| Rate for Payer: Mclaren Medicaid |
$1,394.09
|
| Rate for Payer: Meridian Medicaid |
$1,463.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,827.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,394.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,169.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,169.66
|
| Rate for Payer: UHC Medicaid |
$1,394.09
|
| Rate for Payer: UHCCP Medicaid |
$1,394.09
|
|
|
PR TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR
|
Professional
|
Both
|
$2,225.00
|
|
|
Service Code
|
HCPCS 50770
|
| Min. Negotiated Rate |
$657.11 |
| Max. Negotiated Rate |
$1,870.95 |
| Rate for Payer: Aetna Commercial |
$1,480.02
|
| Rate for Payer: Aetna Medicare |
$1,112.50
|
| Rate for Payer: BCBS Complete |
$689.97
|
| Rate for Payer: BCN Commercial |
$1,717.54
|
| Rate for Payer: Cash Price |
$1,780.00
|
| Rate for Payer: Cash Price |
$1,780.00
|
| Rate for Payer: Mclaren Medicaid |
$657.11
|
| Rate for Payer: Meridian Medicaid |
$689.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,668.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$657.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,870.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,870.95
|
| Rate for Payer: UHC Medicaid |
$657.11
|
| Rate for Payer: UHCCP Medicaid |
$657.11
|
|
|
PR TRANSURETHRAL INCISION PROSTATE
|
Professional
|
Both
|
$1,509.00
|
|
|
Service Code
|
HCPCS 52450
|
| Min. Negotiated Rate |
$603.60 |
| Max. Negotiated Rate |
$1,131.75 |
| Rate for Payer: Aetna Commercial |
$604.49
|
| Rate for Payer: Aetna Medicare |
$754.50
|
| Rate for Payer: BCBS Complete |
$603.60
|
| Rate for Payer: BCN Commercial |
$716.59
|
| Rate for Payer: Cash Price |
$1,207.20
|
| Rate for Payer: Cash Price |
$1,207.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,131.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$780.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$780.61
|
|
