|
PR U-TUBE HEPATICOENTEROSTOMY
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 47802
|
| Min. Negotiated Rate |
$1,126.40 |
| Max. Negotiated Rate |
$2,253.40 |
| Rate for Payer: Aetna Commercial |
$2,068.89
|
| Rate for Payer: Aetna Medicare |
$1,408.00
|
| Rate for Payer: BCBS Complete |
$1,126.40
|
| Rate for Payer: BCN Commercial |
$2,253.40
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,112.00
|
|
|
PR UVULECTOMY EXCISION UVULA
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 42140
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$442.50 |
| Rate for Payer: Aetna Commercial |
$205.69
|
| Rate for Payer: Aetna Medicare |
$295.00
|
| Rate for Payer: BCBS Complete |
$101.77
|
| Rate for Payer: BCN Commercial |
$247.99
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Mclaren Medicaid |
$96.92
|
| Rate for Payer: Meridian Medicaid |
$101.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$302.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$302.17
|
| Rate for Payer: UHC Medicaid |
$96.92
|
| Rate for Payer: UHCCP Medicaid |
$96.92
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY
|
Professional
|
Both
|
$3,218.00
|
|
|
Service Code
|
HCPCS 58291
|
| Min. Negotiated Rate |
$696.72 |
| Max. Negotiated Rate |
$2,413.50 |
| Rate for Payer: Aetna Commercial |
$1,495.94
|
| Rate for Payer: Aetna Medicare |
$1,609.00
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCN Commercial |
$1,859.46
|
| Rate for Payer: Cash Price |
$2,574.40
|
| Rate for Payer: Cash Price |
$2,574.40
|
| Rate for Payer: Mclaren Medicaid |
$696.72
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,413.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,883.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,883.23
|
| Rate for Payer: UHC Medicaid |
$696.72
|
| Rate for Payer: UHCCP Medicaid |
$696.72
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE
|
Professional
|
Both
|
$3,561.00
|
|
|
Service Code
|
HCPCS 58292
|
| Min. Negotiated Rate |
$733.79 |
| Max. Negotiated Rate |
$2,670.75 |
| Rate for Payer: Aetna Commercial |
$1,577.26
|
| Rate for Payer: Aetna Medicare |
$1,780.50
|
| Rate for Payer: BCBS Complete |
$770.48
|
| Rate for Payer: BCN Commercial |
$1,958.56
|
| Rate for Payer: Cash Price |
$2,848.80
|
| Rate for Payer: Cash Price |
$2,848.80
|
| Rate for Payer: Mclaren Medicaid |
$733.79
|
| Rate for Payer: Meridian Medicaid |
$770.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,670.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,983.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,983.60
|
| Rate for Payer: UHC Medicaid |
$733.79
|
| Rate for Payer: UHCCP Medicaid |
$733.79
|
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE&/OVARY
|
Professional
|
Both
|
$3,062.00
|
|
|
Service Code
|
HCPCS 58262
|
| Min. Negotiated Rate |
$522.06 |
| Max. Negotiated Rate |
$2,296.50 |
| Rate for Payer: Aetna Commercial |
$1,109.35
|
| Rate for Payer: Aetna Medicare |
$1,531.00
|
| Rate for Payer: BCBS Complete |
$548.16
|
| Rate for Payer: BCN Commercial |
$1,390.36
|
| Rate for Payer: Cash Price |
$2,449.60
|
| Rate for Payer: Cash Price |
$2,449.60
|
| Rate for Payer: Mclaren Medicaid |
$522.06
|
| Rate for Payer: Meridian Medicaid |
$548.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,296.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$522.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,408.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,408.13
|
| Rate for Payer: UHC Medicaid |
$522.06
|
| Rate for Payer: UHCCP Medicaid |
$522.06
|
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL
|
Professional
|
Both
|
$3,342.00
|
|
|
Service Code
|
HCPCS 58263
|
| Min. Negotiated Rate |
$559.55 |
| Max. Negotiated Rate |
$2,506.50 |
| Rate for Payer: Aetna Commercial |
$1,191.05
|
| Rate for Payer: Aetna Medicare |
$1,671.00
|
| Rate for Payer: BCBS Complete |
$587.53
|
| Rate for Payer: BCN Commercial |
$1,491.46
|
| Rate for Payer: Cash Price |
$2,673.60
|
| Rate for Payer: Cash Price |
$2,673.60
|
| Rate for Payer: Mclaren Medicaid |
$559.55
|
| Rate for Payer: Meridian Medicaid |
$587.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,506.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,510.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,510.52
|
| Rate for Payer: UHC Medicaid |
$559.55
|
| Rate for Payer: UHCCP Medicaid |
$559.55
|
|
|
PR VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE
|
Professional
|
Both
|
$3,844.00
|
|
|
Service Code
|
HCPCS 58280
|
| Min. Negotiated Rate |
$594.70 |
| Max. Negotiated Rate |
$2,883.00 |
| Rate for Payer: Aetna Commercial |
$1,269.75
|
| Rate for Payer: Aetna Medicare |
$1,922.00
|
| Rate for Payer: BCBS Complete |
$624.43
|
| Rate for Payer: BCN Commercial |
$1,586.07
|
| Rate for Payer: Cash Price |
$3,075.20
|
| Rate for Payer: Cash Price |
$3,075.20
|
| Rate for Payer: Mclaren Medicaid |
$594.70
|
| Rate for Payer: Meridian Medicaid |
$624.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,883.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,606.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,606.35
|
| Rate for Payer: UHC Medicaid |
$594.70
|
| Rate for Payer: UHCCP Medicaid |
$594.70
|
|
|
PR VAGINAL DELIVERY AFTER CESAREAN DELIVERY
|
Professional
|
Both
|
$2,209.00
|
|
|
Service Code
|
HCPCS 59612
|
| Min. Negotiated Rate |
$793.18 |
| Max. Negotiated Rate |
$1,674.98 |
| Rate for Payer: Aetna Commercial |
$1,000.61
|
| Rate for Payer: Aetna Medicare |
$1,104.50
|
| Rate for Payer: BCBS Complete |
$832.84
|
| Rate for Payer: BCN Commercial |
$1,674.98
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Mclaren Medicaid |
$793.18
|
| Rate for Payer: Meridian Medicaid |
$832.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$793.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,278.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,278.19
|
| Rate for Payer: UHC Medicaid |
$793.18
|
| Rate for Payer: UHCCP Medicaid |
$793.18
|
|
|
PR VAGINAL DELIVERY ONLY
|
Professional
|
Both
|
$2,029.00
|
|
|
Service Code
|
HCPCS 59409
|
| Min. Negotiated Rate |
$693.27 |
| Max. Negotiated Rate |
$1,595.20 |
| Rate for Payer: Aetna Commercial |
$885.09
|
| Rate for Payer: Aetna Medicare |
$1,014.50
|
| Rate for Payer: BCBS Complete |
$727.93
|
| Rate for Payer: BCN Commercial |
$1,595.20
|
| Rate for Payer: Cash Price |
$1,623.20
|
| Rate for Payer: Cash Price |
$1,623.20
|
| Rate for Payer: Mclaren Medicaid |
$693.27
|
| Rate for Payer: Meridian Medicaid |
$727.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,521.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$693.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,127.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,127.76
|
| Rate for Payer: UHC Medicaid |
$693.27
|
| Rate for Payer: UHCCP Medicaid |
$693.27
|
|
|
PR VAGINAL DELIVERY ONLY W/POSTPARTUM CARE
|
Professional
|
Both
|
$2,309.00
|
|
|
Service Code
|
HCPCS 59410
|
| Min. Negotiated Rate |
$934.83 |
| Max. Negotiated Rate |
$1,851.61 |
| Rate for Payer: Aetna Commercial |
$1,164.53
|
| Rate for Payer: Aetna Medicare |
$1,154.50
|
| Rate for Payer: BCBS Complete |
$981.57
|
| Rate for Payer: BCN Commercial |
$1,851.61
|
| Rate for Payer: Cash Price |
$1,847.20
|
| Rate for Payer: Cash Price |
$1,847.20
|
| Rate for Payer: Mclaren Medicaid |
$934.83
|
| Rate for Payer: Meridian Medicaid |
$981.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,731.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$934.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,527.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,527.34
|
| Rate for Payer: UHC Medicaid |
$934.83
|
| Rate for Payer: UHCCP Medicaid |
$934.83
|
|
|
PR VAGINAL DELIVERY & POSTPARTUM CARE VBAC
|
Professional
|
Both
|
$2,490.00
|
|
|
Service Code
|
HCPCS 59614
|
| Min. Negotiated Rate |
$1,026.23 |
| Max. Negotiated Rate |
$1,944.19 |
| Rate for Payer: Aetna Commercial |
$1,263.20
|
| Rate for Payer: Aetna Medicare |
$1,245.00
|
| Rate for Payer: BCBS Complete |
$1,077.54
|
| Rate for Payer: BCN Commercial |
$1,944.19
|
| Rate for Payer: Cash Price |
$1,992.00
|
| Rate for Payer: Cash Price |
$1,992.00
|
| Rate for Payer: Mclaren Medicaid |
$1,026.23
|
| Rate for Payer: Meridian Medicaid |
$1,077.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,867.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,026.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,651.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,651.92
|
| Rate for Payer: UHC Medicaid |
$1,026.23
|
| Rate for Payer: UHCCP Medicaid |
$1,026.23
|
|
|
PR VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE
|
Professional
|
Both
|
$2,305.00
|
|
|
Service Code
|
HCPCS 58294
|
| Min. Negotiated Rate |
$682.03 |
| Max. Negotiated Rate |
$1,843.38 |
| Rate for Payer: Aetna Commercial |
$1,463.27
|
| Rate for Payer: Aetna Medicare |
$1,152.50
|
| Rate for Payer: BCBS Complete |
$716.13
|
| Rate for Payer: BCN Commercial |
$1,820.12
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Mclaren Medicaid |
$682.03
|
| Rate for Payer: Meridian Medicaid |
$716.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,728.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$682.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,843.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,843.38
|
| Rate for Payer: UHC Medicaid |
$682.03
|
| Rate for Payer: UHCCP Medicaid |
$682.03
|
|
|
PR VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE
|
Professional
|
Both
|
$2,840.00
|
|
|
Service Code
|
HCPCS 58270
|
| Min. Negotiated Rate |
$506.09 |
| Max. Negotiated Rate |
$2,130.00 |
| Rate for Payer: Aetna Commercial |
$1,070.18
|
| Rate for Payer: Aetna Medicare |
$1,420.00
|
| Rate for Payer: BCBS Complete |
$531.39
|
| Rate for Payer: BCN Commercial |
$1,340.57
|
| Rate for Payer: Cash Price |
$2,272.00
|
| Rate for Payer: Cash Price |
$2,272.00
|
| Rate for Payer: Mclaren Medicaid |
$506.09
|
| Rate for Payer: Meridian Medicaid |
$531.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,130.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$506.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,357.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,357.71
|
| Rate for Payer: UHC Medicaid |
$506.09
|
| Rate for Payer: UHCCP Medicaid |
$506.09
|
|
|
PR VAGINAL HYSTERECTOMY UTERUS > 250 GM
|
Professional
|
Both
|
$3,005.00
|
|
|
Service Code
|
HCPCS 58290
|
| Min. Negotiated Rate |
$645.18 |
| Max. Negotiated Rate |
$2,253.75 |
| Rate for Payer: Aetna Commercial |
$1,382.79
|
| Rate for Payer: Aetna Medicare |
$1,502.50
|
| Rate for Payer: BCBS Complete |
$677.44
|
| Rate for Payer: BCN Commercial |
$1,722.02
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Mclaren Medicaid |
$645.18
|
| Rate for Payer: Meridian Medicaid |
$677.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,253.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,744.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,744.03
|
| Rate for Payer: UHC Medicaid |
$645.18
|
| Rate for Payer: UHCCP Medicaid |
$645.18
|
|
|
PR VAGINAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,765.00
|
|
|
Service Code
|
HCPCS 58260
|
| Min. Negotiated Rate |
$473.07 |
| Max. Negotiated Rate |
$2,073.75 |
| Rate for Payer: Aetna Commercial |
$1,002.76
|
| Rate for Payer: Aetna Medicare |
$1,382.50
|
| Rate for Payer: BCBS Complete |
$496.72
|
| Rate for Payer: BCN Commercial |
$1,257.90
|
| Rate for Payer: Cash Price |
$2,212.00
|
| Rate for Payer: Cash Price |
$2,212.00
|
| Rate for Payer: Mclaren Medicaid |
$473.07
|
| Rate for Payer: Meridian Medicaid |
$496.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,073.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,273.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,273.98
|
| Rate for Payer: UHC Medicaid |
$473.07
|
| Rate for Payer: UHCCP Medicaid |
$473.07
|
|
|
PR VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY
|
Professional
|
Both
|
$2,488.00
|
|
|
Service Code
|
HCPCS 58275
|
| Min. Negotiated Rate |
$558.49 |
| Max. Negotiated Rate |
$1,866.00 |
| Rate for Payer: Aetna Commercial |
$1,185.50
|
| Rate for Payer: Aetna Medicare |
$1,244.00
|
| Rate for Payer: BCBS Complete |
$586.41
|
| Rate for Payer: BCN Commercial |
$1,486.97
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Mclaren Medicaid |
$558.49
|
| Rate for Payer: Meridian Medicaid |
$586.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,866.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$558.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,505.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,505.99
|
| Rate for Payer: UHC Medicaid |
$558.49
|
| Rate for Payer: UHCCP Medicaid |
$558.49
|
|
|
PR VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL
|
Professional
|
Both
|
$2,086.00
|
|
|
Service Code
|
HCPCS 57110
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$1,564.50 |
| Rate for Payer: Aetna Commercial |
$1,082.64
|
| Rate for Payer: Aetna Medicare |
$1,043.00
|
| Rate for Payer: BCBS Complete |
$534.30
|
| Rate for Payer: BCN Commercial |
$1,352.51
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Mclaren Medicaid |
$508.86
|
| Rate for Payer: Meridian Medicaid |
$534.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,564.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,369.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,369.80
|
| Rate for Payer: UHC Medicaid |
$508.86
|
| Rate for Payer: UHCCP Medicaid |
$508.86
|
|
|
PR VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL
|
Professional
|
Both
|
$2,053.00
|
|
|
Service Code
|
HCPCS 57106
|
| Min. Negotiated Rate |
$313.96 |
| Max. Negotiated Rate |
$1,539.75 |
| Rate for Payer: Aetna Commercial |
$627.43
|
| Rate for Payer: Aetna Medicare |
$1,026.50
|
| Rate for Payer: BCBS Complete |
$329.66
|
| Rate for Payer: BCN Commercial |
$808.22
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Mclaren Medicaid |
$313.96
|
| Rate for Payer: Meridian Medicaid |
$329.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,539.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$818.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$818.55
|
| Rate for Payer: UHC Medicaid |
$313.96
|
| Rate for Payer: UHCCP Medicaid |
$313.96
|
|
|
PR VAGINOPLASTY INTERSEX STATE
|
Professional
|
Both
|
$2,609.00
|
|
|
Service Code
|
HCPCS 57335
|
| Min. Negotiated Rate |
$660.73 |
| Max. Negotiated Rate |
$1,956.75 |
| Rate for Payer: Aetna Commercial |
$1,408.00
|
| Rate for Payer: Aetna Medicare |
$1,304.50
|
| Rate for Payer: BCBS Complete |
$693.77
|
| Rate for Payer: BCN Commercial |
$1,760.86
|
| Rate for Payer: Cash Price |
$2,087.20
|
| Rate for Payer: Cash Price |
$2,087.20
|
| Rate for Payer: Mclaren Medicaid |
$660.73
|
| Rate for Payer: Meridian Medicaid |
$693.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,956.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$660.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,783.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,783.37
|
| Rate for Payer: UHC Medicaid |
$660.73
|
| Rate for Payer: UHCCP Medicaid |
$660.73
|
|
|
PR VAGNC PRTL RMVL VAG WALL W/RMVL PARAVAGINAL TISS
|
Professional
|
Both
|
$2,648.00
|
|
|
Service Code
|
HCPCS 57107
|
| Min. Negotiated Rate |
$842.42 |
| Max. Negotiated Rate |
$2,214.58 |
| Rate for Payer: Aetna Commercial |
$1,723.00
|
| Rate for Payer: Aetna Medicare |
$1,324.00
|
| Rate for Payer: BCBS Complete |
$884.54
|
| Rate for Payer: BCN Commercial |
$2,186.64
|
| Rate for Payer: Cash Price |
$2,118.40
|
| Rate for Payer: Cash Price |
$2,118.40
|
| Rate for Payer: Mclaren Medicaid |
$842.42
|
| Rate for Payer: Meridian Medicaid |
$884.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,986.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$842.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,214.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,214.58
|
| Rate for Payer: UHC Medicaid |
$842.42
|
| Rate for Payer: UHCCP Medicaid |
$842.42
|
|
|
PR VAGOTOMY PFRMD W/PRTL DSTL GSTRCT
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 43635
|
| Min. Negotiated Rate |
$64.33 |
| Max. Negotiated Rate |
$203.86 |
| Rate for Payer: Aetna Commercial |
$151.79
|
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: BCBS Complete |
$67.55
|
| Rate for Payer: BCN Commercial |
$167.32
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Mclaren Medicaid |
$64.33
|
| Rate for Payer: Meridian Medicaid |
$67.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.86
|
| Rate for Payer: UHC Medicaid |
$64.33
|
| Rate for Payer: UHCCP Medicaid |
$64.33
|
|
|
PR VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP
|
Professional
|
Both
|
$5,005.00
|
|
|
Service Code
|
HCPCS 33460
|
| Min. Negotiated Rate |
$1,431.15 |
| Max. Negotiated Rate |
$3,772.18 |
| Rate for Payer: Aetna Commercial |
$3,229.82
|
| Rate for Payer: Aetna Medicare |
$2,502.50
|
| Rate for Payer: BCBS Complete |
$1,502.71
|
| Rate for Payer: BCN Commercial |
$3,507.77
|
| Rate for Payer: Cash Price |
$4,004.00
|
| Rate for Payer: Cash Price |
$4,004.00
|
| Rate for Payer: Mclaren Medicaid |
$1,431.15
|
| Rate for Payer: Meridian Medicaid |
$1,502.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,753.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,431.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,772.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,772.18
|
| Rate for Payer: UHC Medicaid |
$1,431.15
|
| Rate for Payer: UHCCP Medicaid |
$1,431.15
|
|
|
PR VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS
|
Professional
|
Both
|
$9,191.00
|
|
|
Service Code
|
HCPCS 33422
|
| Min. Negotiated Rate |
$1,012.82 |
| Max. Negotiated Rate |
$6,893.25 |
| Rate for Payer: Aetna Commercial |
$2,232.21
|
| Rate for Payer: Aetna Medicare |
$4,595.50
|
| Rate for Payer: BCBS Complete |
$1,063.46
|
| Rate for Payer: BCN Commercial |
$2,446.58
|
| Rate for Payer: Cash Price |
$7,352.80
|
| Rate for Payer: Cash Price |
$7,352.80
|
| Rate for Payer: Mclaren Medicaid |
$1,012.82
|
| Rate for Payer: Meridian Medicaid |
$1,063.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,893.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,012.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,630.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,630.98
|
| Rate for Payer: UHC Medicaid |
$1,012.82
|
| Rate for Payer: UHCCP Medicaid |
$1,012.82
|
|
|
PR VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS
|
Professional
|
Both
|
$8,768.00
|
|
|
Service Code
|
HCPCS 33425
|
| Min. Negotiated Rate |
$1,626.04 |
| Max. Negotiated Rate |
$6,576.00 |
| Rate for Payer: Aetna Commercial |
$3,670.08
|
| Rate for Payer: Aetna Medicare |
$4,384.00
|
| Rate for Payer: BCBS Complete |
$1,707.34
|
| Rate for Payer: BCN Commercial |
$4,002.28
|
| Rate for Payer: Cash Price |
$7,014.40
|
| Rate for Payer: Cash Price |
$7,014.40
|
| Rate for Payer: Mclaren Medicaid |
$1,626.04
|
| Rate for Payer: Meridian Medicaid |
$1,707.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,576.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,626.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,303.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,303.94
|
| Rate for Payer: UHC Medicaid |
$1,626.04
|
| Rate for Payer: UHCCP Medicaid |
$1,626.04
|
|
|
PR VALVULOPLASTY TRICUSPID VALVE W/O RING INSERTION
|
Professional
|
Both
|
$7,770.00
|
|
|
Service Code
|
HCPCS 33463
|
| Min. Negotiated Rate |
$1,827.33 |
| Max. Negotiated Rate |
$5,827.50 |
| Rate for Payer: Aetna Commercial |
$4,125.63
|
| Rate for Payer: Aetna Medicare |
$3,885.00
|
| Rate for Payer: BCBS Complete |
$1,918.70
|
| Rate for Payer: BCN Commercial |
$4,508.72
|
| Rate for Payer: Cash Price |
$6,216.00
|
| Rate for Payer: Cash Price |
$6,216.00
|
| Rate for Payer: Mclaren Medicaid |
$1,827.33
|
| Rate for Payer: Meridian Medicaid |
$1,918.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,827.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,827.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,848.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,848.55
|
| Rate for Payer: UHC Medicaid |
$1,827.33
|
| Rate for Payer: UHCCP Medicaid |
$1,827.33
|
|
