|
PR URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,822.00
|
|
|
Service Code
|
HCPCS 50900
|
| Min. Negotiated Rate |
$485.43 |
| Max. Negotiated Rate |
$1,373.51 |
| Rate for Payer: Aetna Commercial |
$1,080.97
|
| Rate for Payer: Aetna Medicare |
$911.00
|
| Rate for Payer: BCBS Complete |
$509.70
|
| Rate for Payer: BCN Commercial |
$1,260.88
|
| Rate for Payer: Cash Price |
$1,457.60
|
| Rate for Payer: Cash Price |
$1,457.60
|
| Rate for Payer: Mclaren Medicaid |
$485.43
|
| Rate for Payer: Meridian Medicaid |
$509.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,366.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,373.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.51
|
| Rate for Payer: UHC Medicaid |
$485.43
|
| Rate for Payer: UHCCP Medicaid |
$485.43
|
|
|
PR URETEROTOMY INSERTION INDWELLING STENT ALL TYPES
|
Professional
|
Both
|
$2,095.00
|
|
|
Service Code
|
HCPCS 50605
|
| Min. Negotiated Rate |
$596.83 |
| Max. Negotiated Rate |
$1,645.29 |
| Rate for Payer: Aetna Commercial |
$1,291.91
|
| Rate for Payer: Aetna Medicare |
$1,047.50
|
| Rate for Payer: BCBS Complete |
$626.67
|
| Rate for Payer: BCN Commercial |
$1,510.38
|
| Rate for Payer: Cash Price |
$1,676.00
|
| Rate for Payer: Cash Price |
$1,676.00
|
| Rate for Payer: Mclaren Medicaid |
$596.83
|
| Rate for Payer: Meridian Medicaid |
$626.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,571.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$596.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,645.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,645.29
|
| Rate for Payer: UHC Medicaid |
$596.83
|
| Rate for Payer: UHCCP Medicaid |
$596.83
|
|
|
PR URETEROURETEROSTOMY
|
Professional
|
Both
|
$2,173.00
|
|
|
Service Code
|
HCPCS 50760
|
| Min. Negotiated Rate |
$654.98 |
| Max. Negotiated Rate |
$1,835.70 |
| Rate for Payer: Aetna Commercial |
$1,464.50
|
| Rate for Payer: Aetna Medicare |
$1,086.50
|
| Rate for Payer: BCBS Complete |
$687.73
|
| Rate for Payer: BCN Commercial |
$1,685.17
|
| Rate for Payer: Cash Price |
$1,738.40
|
| Rate for Payer: Cash Price |
$1,738.40
|
| Rate for Payer: Mclaren Medicaid |
$654.98
|
| Rate for Payer: Meridian Medicaid |
$687.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,629.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,835.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,835.70
|
| Rate for Payer: UHC Medicaid |
$654.98
|
| Rate for Payer: UHCCP Medicaid |
$654.98
|
|
|
PR URETHRECTOMY TOT W/CYSTOST MALE
|
Professional
|
Both
|
$1,986.00
|
|
|
Service Code
|
HCPCS 53215
|
| Min. Negotiated Rate |
$531.01 |
| Max. Negotiated Rate |
$1,509.13 |
| Rate for Payer: Aetna Commercial |
$1,189.75
|
| Rate for Payer: Aetna Medicare |
$993.00
|
| Rate for Payer: BCBS Complete |
$557.56
|
| Rate for Payer: BCN Commercial |
$1,385.38
|
| Rate for Payer: Cash Price |
$1,588.80
|
| Rate for Payer: Cash Price |
$1,588.80
|
| Rate for Payer: Mclaren Medicaid |
$531.01
|
| Rate for Payer: Meridian Medicaid |
$557.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,489.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,509.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,509.13
|
| Rate for Payer: UHC Medicaid |
$531.01
|
| Rate for Payer: UHCCP Medicaid |
$531.01
|
|
|
PR URETHROLSS TRVG SEC OPN W/CSTO
|
Professional
|
Both
|
$1,404.00
|
|
|
Service Code
|
HCPCS 53500
|
| Min. Negotiated Rate |
$428.98 |
| Max. Negotiated Rate |
$1,220.55 |
| Rate for Payer: Aetna Commercial |
$964.14
|
| Rate for Payer: Aetna Medicare |
$702.00
|
| Rate for Payer: BCBS Complete |
$450.43
|
| Rate for Payer: BCN Commercial |
$1,120.46
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Mclaren Medicaid |
$428.98
|
| Rate for Payer: Meridian Medicaid |
$450.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,220.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,220.55
|
| Rate for Payer: UHC Medicaid |
$428.98
|
| Rate for Payer: UHCCP Medicaid |
$428.98
|
|
|
PR URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT
|
Professional
|
Both
|
$797.00
|
|
|
Service Code
|
HCPCS 53450
|
| Min. Negotiated Rate |
$241.76 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$523.11
|
| Rate for Payer: Aetna Medicare |
$398.50
|
| Rate for Payer: BCBS Complete |
$253.85
|
| Rate for Payer: BCN Commercial |
$618.00
|
| Rate for Payer: Cash Price |
$637.60
|
| Rate for Payer: Cash Price |
$637.60
|
| Rate for Payer: Mclaren Medicaid |
$241.76
|
| Rate for Payer: Meridian Medicaid |
$253.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$597.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$673.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$673.20
|
| Rate for Payer: UHC Medicaid |
$241.76
|
| Rate for Payer: UHCCP Medicaid |
$241.76
|
|
|
PR URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM
|
Professional
|
Both
|
$1,622.00
|
|
|
Service Code
|
HCPCS 53460
|
| Min. Negotiated Rate |
$268.81 |
| Max. Negotiated Rate |
$1,216.50 |
| Rate for Payer: Aetna Commercial |
$586.56
|
| Rate for Payer: Aetna Medicare |
$811.00
|
| Rate for Payer: BCBS Complete |
$282.25
|
| Rate for Payer: BCN Commercial |
$688.71
|
| Rate for Payer: Cash Price |
$1,297.60
|
| Rate for Payer: Cash Price |
$1,297.60
|
| Rate for Payer: Mclaren Medicaid |
$268.81
|
| Rate for Payer: Meridian Medicaid |
$282.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,216.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$750.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$750.22
|
| Rate for Payer: UHC Medicaid |
$268.81
|
| Rate for Payer: UHCCP Medicaid |
$268.81
|
|
|
PR URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA
|
Professional
|
Both
|
$2,094.00
|
|
|
Service Code
|
HCPCS 53410
|
| Min. Negotiated Rate |
$560.83 |
| Max. Negotiated Rate |
$1,592.13 |
| Rate for Payer: Aetna Commercial |
$1,257.91
|
| Rate for Payer: Aetna Medicare |
$1,047.00
|
| Rate for Payer: BCBS Complete |
$588.87
|
| Rate for Payer: BCN Commercial |
$1,461.57
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Mclaren Medicaid |
$560.83
|
| Rate for Payer: Meridian Medicaid |
$588.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,570.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,592.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,592.13
|
| Rate for Payer: UHC Medicaid |
$560.83
|
| Rate for Payer: UHCCP Medicaid |
$560.83
|
|
|
PR URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX
|
Professional
|
Both
|
$1,570.00
|
|
|
Service Code
|
HCPCS 53400
|
| Min. Negotiated Rate |
$461.57 |
| Max. Negotiated Rate |
$1,307.87 |
| Rate for Payer: Aetna Commercial |
$1,025.75
|
| Rate for Payer: Aetna Medicare |
$785.00
|
| Rate for Payer: BCBS Complete |
$484.65
|
| Rate for Payer: BCN Commercial |
$1,200.63
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Mclaren Medicaid |
$461.57
|
| Rate for Payer: Meridian Medicaid |
$484.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,307.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,307.87
|
| Rate for Payer: UHC Medicaid |
$461.57
|
| Rate for Payer: UHCCP Medicaid |
$461.57
|
|
|
PR URETHROPLASTY 2ND STAGE W/URINARY DIVERSION
|
Professional
|
Both
|
$1,868.00
|
|
|
Service Code
|
HCPCS 53405
|
| Min. Negotiated Rate |
$502.04 |
| Max. Negotiated Rate |
$1,422.88 |
| Rate for Payer: Aetna Commercial |
$1,120.91
|
| Rate for Payer: Aetna Medicare |
$934.00
|
| Rate for Payer: BCBS Complete |
$527.14
|
| Rate for Payer: BCN Commercial |
$1,306.20
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Mclaren Medicaid |
$502.04
|
| Rate for Payer: Meridian Medicaid |
$527.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,401.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,422.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,422.88
|
| Rate for Payer: UHC Medicaid |
$502.04
|
| Rate for Payer: UHCCP Medicaid |
$502.04
|
|
|
PR URETHROPLASTY RCNSTJ FEMALE URETHRA
|
Professional
|
Both
|
$1,817.00
|
|
|
Service Code
|
HCPCS 53430
|
| Min. Negotiated Rate |
$556.78 |
| Max. Negotiated Rate |
$1,584.53 |
| Rate for Payer: Aetna Commercial |
$1,252.24
|
| Rate for Payer: Aetna Medicare |
$908.50
|
| Rate for Payer: BCBS Complete |
$584.62
|
| Rate for Payer: BCN Commercial |
$1,454.60
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Mclaren Medicaid |
$556.78
|
| Rate for Payer: Meridian Medicaid |
$584.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,362.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$556.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,584.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,584.53
|
| Rate for Payer: UHC Medicaid |
$556.78
|
| Rate for Payer: UHCCP Medicaid |
$556.78
|
|
|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE
|
Professional
|
Both
|
$1,006.00
|
|
|
Service Code
|
HCPCS 53502
|
| Min. Negotiated Rate |
$284.99 |
| Max. Negotiated Rate |
$797.97 |
| Rate for Payer: Aetna Commercial |
$622.66
|
| Rate for Payer: Aetna Medicare |
$503.00
|
| Rate for Payer: BCBS Complete |
$299.24
|
| Rate for Payer: BCN Commercial |
$732.53
|
| Rate for Payer: Cash Price |
$804.80
|
| Rate for Payer: Cash Price |
$804.80
|
| Rate for Payer: Mclaren Medicaid |
$284.99
|
| Rate for Payer: Meridian Medicaid |
$299.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$754.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$797.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.97
|
| Rate for Payer: UHC Medicaid |
$284.99
|
| Rate for Payer: UHCCP Medicaid |
$284.99
|
|
|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE
|
Professional
|
Both
|
$951.00
|
|
|
Service Code
|
HCPCS 53505
|
| Min. Negotiated Rate |
$284.78 |
| Max. Negotiated Rate |
$797.41 |
| Rate for Payer: Aetna Commercial |
$622.25
|
| Rate for Payer: Aetna Medicare |
$475.50
|
| Rate for Payer: BCBS Complete |
$299.02
|
| Rate for Payer: BCN Commercial |
$732.03
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Mclaren Medicaid |
$284.78
|
| Rate for Payer: Meridian Medicaid |
$299.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$713.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$797.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.41
|
| Rate for Payer: UHC Medicaid |
$284.78
|
| Rate for Payer: UHCCP Medicaid |
$284.78
|
|
|
PR URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 53010
|
| Min. Negotiated Rate |
$179.35 |
| Max. Negotiated Rate |
$491.47 |
| Rate for Payer: Aetna Commercial |
$376.16
|
| Rate for Payer: Aetna Medicare |
$285.00
|
| Rate for Payer: BCBS Complete |
$188.32
|
| Rate for Payer: BCN Commercial |
$451.17
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Mclaren Medicaid |
$179.35
|
| Rate for Payer: Meridian Medicaid |
$188.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$427.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$491.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.47
|
| Rate for Payer: UHC Medicaid |
$179.35
|
| Rate for Payer: UHCCP Medicaid |
$179.35
|
|
|
PR URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,451.00
|
|
|
Service Code
|
HCPCS 50650
|
| Min. Negotiated Rate |
$593.84 |
| Max. Negotiated Rate |
$2,588.25 |
| Rate for Payer: Aetna Commercial |
$1,331.38
|
| Rate for Payer: Aetna Medicare |
$1,725.50
|
| Rate for Payer: BCBS Complete |
$623.53
|
| Rate for Payer: BCN Commercial |
$1,548.72
|
| Rate for Payer: Cash Price |
$2,760.80
|
| Rate for Payer: Cash Price |
$2,760.80
|
| Rate for Payer: Mclaren Medicaid |
$593.84
|
| Rate for Payer: Meridian Medicaid |
$623.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,588.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,687.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,687.07
|
| Rate for Payer: UHC Medicaid |
$593.84
|
| Rate for Payer: UHCCP Medicaid |
$593.84
|
|
|
PR URINARY LEG OR ABDOMEN BAG
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS A4358
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Aetna Commercial |
$5.46
|
| Rate for Payer: Aetna Medicare |
$4.00
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCN Commercial |
$8.00
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
|
|
PR URINARY SUSPENSORY
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS A5105
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$55.63 |
| Rate for Payer: Aetna Commercial |
$37.97
|
| Rate for Payer: Aetna Medicare |
$34.00
|
| Rate for Payer: BCBS Complete |
$27.20
|
| Rate for Payer: BCN Commercial |
$55.63
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.00
|
|
|
PR URTP W/TUBULARIZATION POST URT&/LWR BLDR
|
Professional
|
Both
|
$2,272.00
|
|
|
Service Code
|
HCPCS 53431
|
| Min. Negotiated Rate |
$657.11 |
| Max. Negotiated Rate |
$1,870.95 |
| Rate for Payer: Aetna Commercial |
$1,480.28
|
| Rate for Payer: Aetna Medicare |
$1,136.00
|
| Rate for Payer: BCBS Complete |
$689.97
|
| Rate for Payer: BCN Commercial |
$1,717.54
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Mclaren Medicaid |
$657.11
|
| Rate for Payer: Meridian Medicaid |
$689.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,704.00
|
| 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 URTROLITHOTOMY MIDDLE ONE-THIRD URETER
|
Professional
|
Both
|
$1,675.00
|
|
|
Service Code
|
HCPCS 50620
|
| Min. Negotiated Rate |
$517.38 |
| Max. Negotiated Rate |
$1,468.45 |
| Rate for Payer: Aetna Commercial |
$1,159.84
|
| Rate for Payer: Aetna Medicare |
$837.50
|
| Rate for Payer: BCBS Complete |
$543.25
|
| Rate for Payer: BCN Commercial |
$1,348.04
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Mclaren Medicaid |
$517.38
|
| Rate for Payer: Meridian Medicaid |
$543.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,256.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,468.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,468.45
|
| Rate for Payer: UHC Medicaid |
$517.38
|
| Rate for Payer: UHCCP Medicaid |
$517.38
|
|
|
PR URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP
|
Professional
|
Both
|
$4,792.00
|
|
|
Service Code
|
HCPCS 50785
|
| Min. Negotiated Rate |
$691.82 |
| Max. Negotiated Rate |
$3,594.00 |
| Rate for Payer: Aetna Commercial |
$1,558.20
|
| Rate for Payer: Aetna Medicare |
$2,396.00
|
| Rate for Payer: BCBS Complete |
$726.41
|
| Rate for Payer: BCN Commercial |
$1,812.15
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Mclaren Medicaid |
$691.82
|
| Rate for Payer: Meridian Medicaid |
$726.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,594.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,974.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,974.03
|
| Rate for Payer: UHC Medicaid |
$691.82
|
| Rate for Payer: UHCCP Medicaid |
$691.82
|
|
|
PR URTT/URTS XTRNL SPX PENDULOUS URETHRA
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 53000
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$243.57 |
| Rate for Payer: Aetna Commercial |
$189.14
|
| Rate for Payer: Aetna Medicare |
$144.50
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCN Commercial |
$223.60
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Mclaren Medicaid |
$88.40
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$243.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$243.57
|
| Rate for Payer: UHC Medicaid |
$88.40
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR USE OF ECHO CONTRAST AGENT DURING STRESS ECHO
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 93352
|
| Min. Negotiated Rate |
$33.50 |
| Max. Negotiated Rate |
$52.29 |
| Rate for Payer: Aetna Commercial |
$42.92
|
| Rate for Payer: Aetna Medicare |
$33.50
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.69
|
|
|
PR USE VERTICAL ELECTRODES
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 92547
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Aetna Commercial |
$10.32
|
| Rate for Payer: Aetna Medicare |
$11.50
|
| Rate for Payer: BCN Commercial |
$15.44
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.24
|
|
|
PR UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 59870
|
| Min. Negotiated Rate |
$307.79 |
| Max. Negotiated Rate |
$806.23 |
| Rate for Payer: Aetna Commercial |
$572.00
|
| Rate for Payer: Aetna Medicare |
$404.50
|
| Rate for Payer: BCBS Complete |
$323.18
|
| Rate for Payer: BCN Commercial |
$806.23
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Mclaren Medicaid |
$307.79
|
| Rate for Payer: Meridian Medicaid |
$323.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$761.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$761.09
|
| Rate for Payer: UHC Medicaid |
$307.79
|
| Rate for Payer: UHCCP Medicaid |
$307.79
|
|
|
PR UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 58400
|
| Min. Negotiated Rate |
$265.19 |
| Max. Negotiated Rate |
$702.05 |
| Rate for Payer: Aetna Commercial |
$547.93
|
| Rate for Payer: Aetna Medicare |
$445.00
|
| Rate for Payer: BCBS Complete |
$278.45
|
| Rate for Payer: BCN Commercial |
$693.19
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Mclaren Medicaid |
$265.19
|
| Rate for Payer: Meridian Medicaid |
$278.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$702.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$702.05
|
| Rate for Payer: UHC Medicaid |
$265.19
|
| Rate for Payer: UHCCP Medicaid |
$265.19
|
|
