|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
IP
|
$2,545.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,654.25 |
| Max. Negotiated Rate |
$2,290.50 |
| Rate for Payer: Aetna Commercial |
$2,163.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.48
|
| Rate for Payer: BCN Commercial |
$1,966.78
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$2,188.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.00
|
| Rate for Payer: Healthscope Commercial |
$2,290.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.25
|
| Rate for Payer: Nomi Health Commercial |
$2,086.90
|
| Rate for Payer: PHP Commercial |
$2,163.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health HMO/PPO |
$2,214.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,705.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,239.60
|
| Rate for Payer: UHC Core |
$2,125.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.75
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$455.82 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$912.37
|
| Rate for Payer: Aetna Medicare |
$708.10
|
| Rate for Payer: BCBS Complete |
$478.61
|
| Rate for Payer: BCBS MAPPO |
$680.87
|
| Rate for Payer: BCBS Trust/PPO |
$484.45
|
| Rate for Payer: BCN Commercial |
$1,036.00
|
| Rate for Payer: BCN Medicare Advantage |
$680.87
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$980.45
|
| Rate for Payer: Cofinity Commercial |
$912.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.87
|
| Rate for Payer: Mclaren Medicaid |
$455.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.91
|
| Rate for Payer: Meridian Medicaid |
$478.61
|
| Rate for Payer: Nomi Health Commercial |
$817.04
|
| Rate for Payer: PACE SWMI |
$680.87
|
| Rate for Payer: PHP Medicare Advantage |
$680.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,147.54
|
| Rate for Payer: Priority Health Medicare |
$687.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,147.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.87
|
| Rate for Payer: UHC Exchange |
$680.87
|
| Rate for Payer: UHC Medicare Advantage |
$680.87
|
| Rate for Payer: UHCCP Medicaid |
$455.82
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Min. Negotiated Rate |
$455.82 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$912.37
|
| Rate for Payer: Aetna Medicare |
$708.10
|
| Rate for Payer: BCBS Complete |
$478.61
|
| Rate for Payer: BCBS MAPPO |
$680.87
|
| Rate for Payer: BCBS Trust/PPO |
$484.45
|
| Rate for Payer: BCN Commercial |
$1,036.00
|
| Rate for Payer: BCN Medicare Advantage |
$680.87
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$980.45
|
| Rate for Payer: Cofinity Commercial |
$912.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.87
|
| Rate for Payer: Mclaren Medicaid |
$455.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.91
|
| Rate for Payer: Meridian Medicaid |
$478.61
|
| Rate for Payer: Nomi Health Commercial |
$817.04
|
| Rate for Payer: PACE SWMI |
$680.87
|
| Rate for Payer: PHP Medicare Advantage |
$680.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,147.54
|
| Rate for Payer: Priority Health Medicare |
$687.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,147.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.87
|
| Rate for Payer: UHC Exchange |
$680.87
|
| Rate for Payer: UHC Medicare Advantage |
$680.87
|
| Rate for Payer: UHCCP Medicaid |
$455.82
|
|
|
PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$1,437.00
|
|
|
Service Code
|
HCPCS 60225
|
| Min. Negotiated Rate |
$566.87 |
| Max. Negotiated Rate |
$1,521.79 |
| Rate for Payer: Aetna Commercial |
$1,212.03
|
| Rate for Payer: Aetna Medicare |
$940.68
|
| Rate for Payer: BCBS Complete |
$635.39
|
| Rate for Payer: BCBS MAPPO |
$904.50
|
| Rate for Payer: BCBS Trust/PPO |
$566.87
|
| Rate for Payer: BCN Commercial |
$1,368.79
|
| Rate for Payer: BCN Medicare Advantage |
$904.50
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cofinity Commercial |
$1,302.48
|
| Rate for Payer: Cofinity Commercial |
$1,212.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.50
|
| Rate for Payer: Mclaren Medicaid |
$605.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.72
|
| Rate for Payer: Meridian Medicaid |
$635.39
|
| Rate for Payer: Nomi Health Commercial |
$1,085.40
|
| Rate for Payer: PACE SWMI |
$904.50
|
| Rate for Payer: PHP Medicare Advantage |
$904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$605.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$934.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,521.79
|
| Rate for Payer: Priority Health Medicare |
$913.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,521.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$904.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$904.50
|
| Rate for Payer: UHC Exchange |
$904.50
|
| Rate for Payer: UHC Medicare Advantage |
$904.50
|
| Rate for Payer: UHCCP Medicaid |
$605.13
|
|
|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,574.00
|
|
|
Service Code
|
HCPCS 43107
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$5,260.17 |
| Rate for Payer: Aetna Commercial |
$3,831.80
|
| Rate for Payer: Aetna Medicare |
$2,973.93
|
| Rate for Payer: BCBS Complete |
$1,975.28
|
| Rate for Payer: BCBS MAPPO |
$2,859.55
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$4,291.08
|
| Rate for Payer: BCN Medicare Advantage |
$2,859.55
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cofinity Commercial |
$4,117.75
|
| Rate for Payer: Cofinity Commercial |
$3,831.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,859.55
|
| Rate for Payer: Mclaren Medicaid |
$1,881.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,002.53
|
| Rate for Payer: Meridian Medicaid |
$1,975.28
|
| Rate for Payer: Nomi Health Commercial |
$3,431.46
|
| Rate for Payer: PACE SWMI |
$2,859.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,859.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,881.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health HMO/PPO |
$5,260.17
|
| Rate for Payer: Priority Health Medicare |
$2,888.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,260.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,859.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,859.55
|
| Rate for Payer: UHC Exchange |
$2,859.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,859.55
|
| Rate for Payer: UHCCP Medicaid |
$1,881.22
|
|
|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$7,965.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$79.81 |
| Max. Negotiated Rate |
$6,699.15 |
| Rate for Payer: Aetna Commercial |
$4,903.34
|
| Rate for Payer: Aetna Medicare |
$3,805.58
|
| Rate for Payer: BCBS Complete |
$2,517.63
|
| Rate for Payer: BCBS MAPPO |
$3,659.21
|
| Rate for Payer: BCBS Trust/PPO |
$79.81
|
| Rate for Payer: BCN Commercial |
$5,466.34
|
| Rate for Payer: BCN Medicare Advantage |
$3,659.21
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cofinity Commercial |
$5,269.26
|
| Rate for Payer: Cofinity Commercial |
$4,903.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,659.21
|
| Rate for Payer: Mclaren Medicaid |
$2,397.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,842.17
|
| Rate for Payer: Meridian Medicaid |
$2,517.63
|
| Rate for Payer: Nomi Health Commercial |
$4,391.05
|
| Rate for Payer: PACE SWMI |
$3,659.21
|
| Rate for Payer: PHP Medicare Advantage |
$3,659.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,397.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,177.25
|
| Rate for Payer: Priority Health HMO/PPO |
$6,699.15
|
| Rate for Payer: Priority Health Medicare |
$3,695.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,699.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,659.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,659.21
|
| Rate for Payer: UHC Exchange |
$3,659.21
|
| Rate for Payer: UHC Medicare Advantage |
$3,659.21
|
| Rate for Payer: UHCCP Medicaid |
$2,397.74
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,232.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$129.72 |
| Max. Negotiated Rate |
$800.80 |
| Rate for Payer: Aetna Commercial |
$254.65
|
| Rate for Payer: Aetna Medicare |
$197.64
|
| Rate for Payer: BCBS Complete |
$136.21
|
| Rate for Payer: BCBS MAPPO |
$190.04
|
| Rate for Payer: BCBS Trust/PPO |
$406.79
|
| Rate for Payer: BCN Commercial |
$285.08
|
| Rate for Payer: BCN Medicare Advantage |
$190.04
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cofinity Commercial |
$273.66
|
| Rate for Payer: Cofinity Commercial |
$254.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.04
|
| Rate for Payer: Mclaren Medicaid |
$129.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.54
|
| Rate for Payer: Meridian Medicaid |
$136.21
|
| Rate for Payer: Nomi Health Commercial |
$228.05
|
| Rate for Payer: PACE SWMI |
$190.04
|
| Rate for Payer: PHP Medicare Advantage |
$190.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.80
|
| Rate for Payer: Priority Health HMO/PPO |
$356.21
|
| Rate for Payer: Priority Health Medicare |
$191.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$356.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.04
|
| Rate for Payer: UHC Exchange |
$190.04
|
| Rate for Payer: UHC Medicare Advantage |
$190.04
|
| Rate for Payer: UHCCP Medicaid |
$129.72
|
|
|
PR TRACHEAL PNXR PERQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$1,068.75 |
| Rate for Payer: Aetna Commercial |
$62.47
|
| Rate for Payer: Aetna Medicare |
$48.48
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$46.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,068.75
|
| Rate for Payer: BCN Commercial |
$137.81
|
| Rate for Payer: BCN Medicare Advantage |
$46.62
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$67.13
|
| Rate for Payer: Cofinity Commercial |
$62.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.62
|
| Rate for Payer: Mclaren Medicaid |
$30.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.95
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Nomi Health Commercial |
$55.94
|
| Rate for Payer: PACE SWMI |
$46.62
|
| Rate for Payer: PHP Medicare Advantage |
$46.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.05
|
| Rate for Payer: Priority Health HMO/PPO |
$66.27
|
| Rate for Payer: Priority Health Medicare |
$47.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.62
|
| Rate for Payer: UHC Exchange |
$46.62
|
| Rate for Payer: UHC Medicare Advantage |
$46.62
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
|
|
PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX
|
Professional
|
Both
|
$581.00
|
|
|
Service Code
|
HCPCS 57530
|
| Min. Negotiated Rate |
$241.33 |
| Max. Negotiated Rate |
$1,900.30 |
| Rate for Payer: Aetna Commercial |
$477.59
|
| Rate for Payer: Aetna Medicare |
$370.67
|
| Rate for Payer: BCBS Complete |
$253.40
|
| Rate for Payer: BCBS MAPPO |
$356.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,900.30
|
| Rate for Payer: BCN Commercial |
$550.25
|
| Rate for Payer: BCN Medicare Advantage |
$356.41
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cofinity Commercial |
$513.23
|
| Rate for Payer: Cofinity Commercial |
$477.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.41
|
| Rate for Payer: Mclaren Medicaid |
$241.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.23
|
| Rate for Payer: Meridian Medicaid |
$253.40
|
| Rate for Payer: Nomi Health Commercial |
$427.69
|
| Rate for Payer: PACE SWMI |
$356.41
|
| Rate for Payer: PHP Medicare Advantage |
$356.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.65
|
| Rate for Payer: Priority Health HMO/PPO |
$563.52
|
| Rate for Payer: Priority Health Medicare |
$359.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$563.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.41
|
| Rate for Payer: UHC Exchange |
$356.41
|
| Rate for Payer: UHC Medicare Advantage |
$356.41
|
| Rate for Payer: UHCCP Medicaid |
$241.33
|
|
|
PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 57720
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$425.96
|
| Rate for Payer: Aetna Medicare |
$330.60
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCBS MAPPO |
$317.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: BCN Commercial |
$493.07
|
| Rate for Payer: BCN Medicare Advantage |
$317.88
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$457.75
|
| Rate for Payer: Cofinity Commercial |
$425.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.88
|
| Rate for Payer: Mclaren Medicaid |
$215.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.77
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Nomi Health Commercial |
$381.46
|
| Rate for Payer: PACE SWMI |
$317.88
|
| Rate for Payer: PHP Medicare Advantage |
$317.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health HMO/PPO |
$503.00
|
| Rate for Payer: Priority Health Medicare |
$321.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.88
|
| Rate for Payer: UHC Exchange |
$317.88
|
| Rate for Payer: UHC Medicare Advantage |
$317.88
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
|
|
PR TRACHEOBRONCHOSCOPY THRU EST TRACHEOSTOMY INC
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS 31615
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$1,672.60 |
| Rate for Payer: Aetna Commercial |
$147.35
|
| Rate for Payer: Aetna Medicare |
$114.36
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$109.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,672.60
|
| Rate for Payer: BCN Commercial |
$253.14
|
| Rate for Payer: BCN Medicare Advantage |
$109.96
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cofinity Commercial |
$158.34
|
| Rate for Payer: Cofinity Commercial |
$147.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.96
|
| Rate for Payer: Mclaren Medicaid |
$74.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.46
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$131.95
|
| Rate for Payer: PACE SWMI |
$109.96
|
| Rate for Payer: PHP Medicare Advantage |
$109.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.30
|
| Rate for Payer: Priority Health HMO/PPO |
$160.35
|
| Rate for Payer: Priority Health Medicare |
$111.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.96
|
| Rate for Payer: UHC Exchange |
$109.96
|
| Rate for Payer: UHC Medicare Advantage |
$109.96
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
|
|
PR TRACHEOPLASTY CERVICAL
|
Professional
|
Both
|
$4,405.00
|
|
|
Service Code
|
HCPCS 31750
|
| Min. Negotiated Rate |
$863.29 |
| Max. Negotiated Rate |
$2,863.25 |
| Rate for Payer: Aetna Commercial |
$1,685.65
|
| Rate for Payer: Aetna Medicare |
$1,308.27
|
| Rate for Payer: BCBS Complete |
$906.45
|
| Rate for Payer: BCBS MAPPO |
$1,257.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,349.28
|
| Rate for Payer: BCN Commercial |
$1,995.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.95
|
| Rate for Payer: Cash Price |
$3,524.00
|
| Rate for Payer: Cash Price |
$3,524.00
|
| Rate for Payer: Cofinity Commercial |
$1,811.45
|
| Rate for Payer: Cofinity Commercial |
$1,685.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.95
|
| Rate for Payer: Mclaren Medicaid |
$863.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.85
|
| Rate for Payer: Meridian Medicaid |
$906.45
|
| Rate for Payer: Nomi Health Commercial |
$1,509.54
|
| Rate for Payer: PACE SWMI |
$1,257.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$863.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,863.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,880.75
|
| Rate for Payer: Priority Health Medicare |
$1,270.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,880.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,257.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.95
|
| Rate for Payer: UHC Exchange |
$1,257.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.95
|
| Rate for Payer: UHCCP Medicaid |
$863.29
|
|
|
PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
|
Professional
|
Both
|
$1,355.00
|
|
|
Service Code
|
HCPCS 31614
|
| Min. Negotiated Rate |
$455.82 |
| Max. Negotiated Rate |
$1,319.17 |
| Rate for Payer: Aetna Commercial |
$893.18
|
| Rate for Payer: Aetna Medicare |
$693.21
|
| Rate for Payer: BCBS Complete |
$478.61
|
| Rate for Payer: BCBS MAPPO |
$666.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,319.17
|
| Rate for Payer: BCN Commercial |
$1,052.12
|
| Rate for Payer: BCN Medicare Advantage |
$666.55
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cofinity Commercial |
$959.83
|
| Rate for Payer: Cofinity Commercial |
$893.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.55
|
| Rate for Payer: Mclaren Medicaid |
$455.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$699.88
|
| Rate for Payer: Meridian Medicaid |
$478.61
|
| Rate for Payer: Nomi Health Commercial |
$799.86
|
| Rate for Payer: PACE SWMI |
$666.55
|
| Rate for Payer: PHP Medicare Advantage |
$666.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$880.75
|
| Rate for Payer: Priority Health HMO/PPO |
$995.53
|
| Rate for Payer: Priority Health Medicare |
$673.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$995.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$666.55
|
| Rate for Payer: UHC Exchange |
$666.55
|
| Rate for Payer: UHC Medicare Advantage |
$666.55
|
| Rate for Payer: UHCCP Medicaid |
$455.82
|
|
|
PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 31613
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$1,181.81 |
| Rate for Payer: Aetna Commercial |
$528.39
|
| Rate for Payer: Aetna Medicare |
$410.09
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$394.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.81
|
| Rate for Payer: BCN Commercial |
$625.99
|
| Rate for Payer: BCN Medicare Advantage |
$394.32
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$567.82
|
| Rate for Payer: Cofinity Commercial |
$528.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.32
|
| Rate for Payer: Mclaren Medicaid |
$270.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.04
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Nomi Health Commercial |
$473.18
|
| Rate for Payer: PACE SWMI |
$394.32
|
| Rate for Payer: PHP Medicare Advantage |
$394.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.80
|
| Rate for Payer: Priority Health HMO/PPO |
$593.24
|
| Rate for Payer: Priority Health Medicare |
$398.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$593.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.32
|
| Rate for Payer: UHC Exchange |
$394.32
|
| Rate for Payer: UHC Medicare Advantage |
$394.32
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 31605
|
| Min. Negotiated Rate |
$210.23 |
| Max. Negotiated Rate |
$525.85 |
| Rate for Payer: Aetna Commercial |
$429.04
|
| Rate for Payer: Aetna Medicare |
$332.99
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS MAPPO |
$320.18
|
| Rate for Payer: BCBS Trust/PPO |
$424.08
|
| Rate for Payer: BCN Commercial |
$481.35
|
| Rate for Payer: BCN Medicare Advantage |
$320.18
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$461.06
|
| Rate for Payer: Cofinity Commercial |
$429.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.18
|
| Rate for Payer: Mclaren Medicaid |
$210.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.19
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Nomi Health Commercial |
$384.22
|
| Rate for Payer: PACE SWMI |
$320.18
|
| Rate for Payer: PHP Medicare Advantage |
$320.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health HMO/PPO |
$453.73
|
| Rate for Payer: Priority Health Medicare |
$323.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$453.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.18
|
| Rate for Payer: UHC Exchange |
$320.18
|
| Rate for Payer: UHC Medicare Advantage |
$320.18
|
| Rate for Payer: UHCCP Medicaid |
$210.23
|
|
|
PR TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 31603
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$1,439.09 |
| Rate for Payer: Aetna Commercial |
$410.59
|
| Rate for Payer: Aetna Medicare |
$318.67
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$306.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,439.09
|
| Rate for Payer: BCN Commercial |
$464.73
|
| Rate for Payer: BCN Medicare Advantage |
$306.41
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cofinity Commercial |
$441.23
|
| Rate for Payer: Cofinity Commercial |
$410.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.41
|
| Rate for Payer: Mclaren Medicaid |
$202.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.73
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Nomi Health Commercial |
$367.69
|
| Rate for Payer: PACE SWMI |
$306.41
|
| Rate for Payer: PHP Medicare Advantage |
$306.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.85
|
| Rate for Payer: Priority Health HMO/PPO |
$440.75
|
| Rate for Payer: Priority Health Medicare |
$309.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$440.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.41
|
| Rate for Payer: UHC Exchange |
$306.41
|
| Rate for Payer: UHC Medicare Advantage |
$306.41
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
|
|
PR TRACHEOSTOMY FENESTRATION W/SKIN FLAPS
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 31610
|
| Min. Negotiated Rate |
$610.88 |
| Max. Negotiated Rate |
$1,410.81 |
| Rate for Payer: Aetna Commercial |
$1,200.12
|
| Rate for Payer: Aetna Medicare |
$931.43
|
| Rate for Payer: BCBS Complete |
$641.42
|
| Rate for Payer: BCBS MAPPO |
$895.61
|
| Rate for Payer: BCBS Trust/PPO |
$825.73
|
| Rate for Payer: BCN Commercial |
$1,410.81
|
| Rate for Payer: BCN Medicare Advantage |
$895.61
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cofinity Commercial |
$1,289.68
|
| Rate for Payer: Cofinity Commercial |
$1,200.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$895.61
|
| Rate for Payer: Mclaren Medicaid |
$610.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$940.39
|
| Rate for Payer: Meridian Medicaid |
$641.42
|
| Rate for Payer: Nomi Health Commercial |
$1,074.73
|
| Rate for Payer: PACE SWMI |
$895.61
|
| Rate for Payer: PHP Medicare Advantage |
$895.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$610.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,335.24
|
| Rate for Payer: Priority Health Medicare |
$904.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,335.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$895.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$895.61
|
| Rate for Payer: UHC Exchange |
$895.61
|
| Rate for Payer: UHC Medicare Advantage |
$895.61
|
| Rate for Payer: UHCCP Medicaid |
$610.88
|
|
|
PR TRACHEOSTOMY PLANNED SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 31600
|
| Min. Negotiated Rate |
$193.40 |
| Max. Negotiated Rate |
$753.88 |
| Rate for Payer: Aetna Commercial |
$391.80
|
| Rate for Payer: Aetna Medicare |
$304.09
|
| Rate for Payer: BCBS Complete |
$203.07
|
| Rate for Payer: BCBS MAPPO |
$292.39
|
| Rate for Payer: BCBS Trust/PPO |
$753.88
|
| Rate for Payer: BCN Commercial |
$442.74
|
| Rate for Payer: BCN Medicare Advantage |
$292.39
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$421.04
|
| Rate for Payer: Cofinity Commercial |
$391.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.39
|
| Rate for Payer: Mclaren Medicaid |
$193.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.01
|
| Rate for Payer: Meridian Medicaid |
$203.07
|
| Rate for Payer: Nomi Health Commercial |
$350.87
|
| Rate for Payer: PACE SWMI |
$292.39
|
| Rate for Payer: PHP Medicare Advantage |
$292.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health HMO/PPO |
$420.37
|
| Rate for Payer: Priority Health Medicare |
$295.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$420.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.39
|
| Rate for Payer: UHC Exchange |
$292.39
|
| Rate for Payer: UHC Medicare Advantage |
$292.39
|
| Rate for Payer: UHCCP Medicaid |
$193.40
|
|
|
PR TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 31601
|
| Min. Negotiated Rate |
$286.27 |
| Max. Negotiated Rate |
$1,079.85 |
| Rate for Payer: Aetna Commercial |
$574.74
|
| Rate for Payer: Aetna Medicare |
$446.07
|
| Rate for Payer: BCBS Complete |
$300.58
|
| Rate for Payer: BCBS MAPPO |
$428.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.85
|
| Rate for Payer: BCN Commercial |
$653.36
|
| Rate for Payer: BCN Medicare Advantage |
$428.91
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cofinity Commercial |
$617.63
|
| Rate for Payer: Cofinity Commercial |
$574.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.91
|
| Rate for Payer: Mclaren Medicaid |
$286.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.36
|
| Rate for Payer: Meridian Medicaid |
$300.58
|
| Rate for Payer: Nomi Health Commercial |
$514.69
|
| Rate for Payer: PACE SWMI |
$428.91
|
| Rate for Payer: PHP Medicare Advantage |
$428.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health HMO/PPO |
$621.51
|
| Rate for Payer: Priority Health Medicare |
$433.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$621.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$428.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.91
|
| Rate for Payer: UHC Exchange |
$428.91
|
| Rate for Payer: UHC Medicare Advantage |
$428.91
|
| Rate for Payer: UHCCP Medicaid |
$286.27
|
|
|
PR TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 31502
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$1,778.79 |
| Rate for Payer: Aetna Commercial |
$44.09
|
| Rate for Payer: Aetna Medicare |
$34.22
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCBS MAPPO |
$32.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,778.79
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: BCN Medicare Advantage |
$32.90
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$47.38
|
| Rate for Payer: Cofinity Commercial |
$44.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.90
|
| Rate for Payer: Mclaren Medicaid |
$21.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.54
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Nomi Health Commercial |
$39.48
|
| Rate for Payer: PACE SWMI |
$32.90
|
| Rate for Payer: PHP Medicare Advantage |
$32.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health HMO/PPO |
$48.20
|
| Rate for Payer: Priority Health Medicare |
$33.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.90
|
| Rate for Payer: UHC Exchange |
$32.90
|
| Rate for Payer: UHC Medicare Advantage |
$32.90
|
| Rate for Payer: UHCCP Medicaid |
$21.94
|
|
|
PR TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I
|
Professional
|
Both
|
$1,385.00
|
|
|
Service Code
|
HCPCS 34712
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$1,464.98 |
| Rate for Payer: Aetna Commercial |
$838.21
|
| Rate for Payer: Aetna Medicare |
$650.55
|
| Rate for Payer: BCBS Complete |
$430.08
|
| Rate for Payer: BCBS MAPPO |
$625.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,464.98
|
| Rate for Payer: BCN Commercial |
$936.79
|
| Rate for Payer: BCN Medicare Advantage |
$625.53
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cofinity Commercial |
$900.76
|
| Rate for Payer: Cofinity Commercial |
$838.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.53
|
| Rate for Payer: Mclaren Medicaid |
$409.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.81
|
| Rate for Payer: Meridian Medicaid |
$430.08
|
| Rate for Payer: Nomi Health Commercial |
$750.64
|
| Rate for Payer: PACE SWMI |
$625.53
|
| Rate for Payer: PHP Medicare Advantage |
$625.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,021.10
|
| Rate for Payer: Priority Health Medicare |
$631.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,021.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.53
|
| Rate for Payer: UHC Exchange |
$625.53
|
| Rate for Payer: UHC Medicare Advantage |
$625.53
|
| Rate for Payer: UHCCP Medicaid |
$409.60
|
|
|
PR TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE
|
Professional
|
Both
|
$5,665.00
|
|
|
Service Code
|
HCPCS 33366
|
| Min. Negotiated Rate |
$982.14 |
| Max. Negotiated Rate |
$3,682.25 |
| Rate for Payer: Aetna Commercial |
$2,010.83
|
| Rate for Payer: Aetna Medicare |
$1,560.64
|
| Rate for Payer: BCBS Complete |
$1,031.25
|
| Rate for Payer: BCBS MAPPO |
$1,500.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,001.66
|
| Rate for Payer: BCN Commercial |
$2,244.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,500.62
|
| Rate for Payer: Cash Price |
$4,532.00
|
| Rate for Payer: Cash Price |
$4,532.00
|
| Rate for Payer: Cofinity Commercial |
$2,160.89
|
| Rate for Payer: Cofinity Commercial |
$2,010.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,500.62
|
| Rate for Payer: Mclaren Medicaid |
$982.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,575.65
|
| Rate for Payer: Meridian Medicaid |
$1,031.25
|
| Rate for Payer: Nomi Health Commercial |
$1,800.74
|
| Rate for Payer: PACE SWMI |
$1,500.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,500.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$982.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,682.25
|
| Rate for Payer: Priority Health HMO/PPO |
$2,442.14
|
| Rate for Payer: Priority Health Medicare |
$1,515.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,442.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,500.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,500.62
|
| Rate for Payer: UHC Exchange |
$1,500.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,500.62
|
| Rate for Payer: UHCCP Medicaid |
$982.14
|
|
|
PR TRANSCATH INSERT OR REPLACE LEADLESS PM VENTR
|
Professional
|
Both
|
$1,630.00
|
|
|
Service Code
|
HCPCS 0387T
|
| Min. Negotiated Rate |
$652.00 |
| Max. Negotiated Rate |
$1,059.50 |
| Rate for Payer: Aetna Medicare |
$815.00
|
| Rate for Payer: BCBS Complete |
$652.00
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,059.50
|
|
|
PR TRANSCATH INTRO, STENT, EXCL COR, CAROT, VERT
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 75960
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$77.35 |
| Rate for Payer: Aetna Medicare |
$59.50
|
| Rate for Payer: BCBS Complete |
$47.60
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
|
|
PR TRANSCATH OCCLUSION,PERCUT
|
Professional
|
Both
|
$1,856.00
|
|
|
Service Code
|
HCPCS 37204
|
| Min. Negotiated Rate |
$742.40 |
| Max. Negotiated Rate |
$1,206.40 |
| Rate for Payer: Aetna Medicare |
$928.00
|
| Rate for Payer: BCBS Complete |
$742.40
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.40
|
|
