|
PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 57720
|
| Min. Negotiated Rate |
$317.88 |
| Max. Negotiated Rate |
$618.80 |
| Rate for Payer: Aetna Commercial |
$425.96
|
| Rate for Payer: Aetna Medicare |
$330.60
|
| Rate for Payer: BCBS Complete |
$380.80
|
| Rate for Payer: BCBS MAPPO |
$317.88
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.77
|
| 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 Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health Medicare |
$321.06
|
| 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
|
|
|
PR TRACHEOBRONCHOSCOPY THRU EST TRACHEOSTOMY INC
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS 31615
|
| Min. Negotiated Rate |
$109.96 |
| Max. Negotiated Rate |
$300.30 |
| Rate for Payer: Aetna Commercial |
$147.35
|
| Rate for Payer: Aetna Medicare |
$114.36
|
| Rate for Payer: BCBS Complete |
$184.80
|
| Rate for Payer: BCBS MAPPO |
$109.96
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.46
|
| 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 Cigna Priority Health |
$300.30
|
| Rate for Payer: Priority Health Medicare |
$111.06
|
| 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
|
|
|
PR TRACHEOPLASTY CERVICAL
|
Professional
|
Both
|
$4,405.00
|
|
|
Service Code
|
HCPCS 31750
|
| Min. Negotiated Rate |
$1,257.95 |
| 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 |
$1,762.00
|
| Rate for Payer: BCBS MAPPO |
$1,257.95
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.85
|
| 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 Cigna Priority Health |
$2,863.25
|
| Rate for Payer: Priority Health Medicare |
$1,270.53
|
| 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
|
|
|
PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
|
Professional
|
Both
|
$1,355.00
|
|
|
Service Code
|
HCPCS 31614
|
| Min. Negotiated Rate |
$542.00 |
| Max. Negotiated Rate |
$959.83 |
| Rate for Payer: Aetna Commercial |
$893.18
|
| Rate for Payer: Aetna Medicare |
$693.21
|
| Rate for Payer: BCBS Complete |
$542.00
|
| Rate for Payer: BCBS MAPPO |
$666.55
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$699.88
|
| 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 Cigna Priority Health |
$880.75
|
| Rate for Payer: Priority Health Medicare |
$673.22
|
| 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
|
|
|
PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 31613
|
| Min. Negotiated Rate |
$364.80 |
| Max. Negotiated Rate |
$592.80 |
| Rate for Payer: Aetna Commercial |
$528.39
|
| Rate for Payer: Aetna Medicare |
$410.09
|
| Rate for Payer: BCBS Complete |
$364.80
|
| Rate for Payer: BCBS MAPPO |
$394.32
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.04
|
| 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 Cigna Priority Health |
$592.80
|
| Rate for Payer: Priority Health Medicare |
$398.26
|
| 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
|
|
|
PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 31605
|
| Min. Negotiated Rate |
$320.18 |
| Max. Negotiated Rate |
$525.85 |
| Rate for Payer: Aetna Commercial |
$429.04
|
| Rate for Payer: Aetna Medicare |
$332.99
|
| Rate for Payer: BCBS Complete |
$323.60
|
| Rate for Payer: BCBS MAPPO |
$320.18
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.19
|
| 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 Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health Medicare |
$323.38
|
| 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
|
|
|
PR TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 31603
|
| Min. Negotiated Rate |
$306.41 |
| Max. Negotiated Rate |
$772.85 |
| Rate for Payer: Aetna Commercial |
$410.59
|
| Rate for Payer: Aetna Medicare |
$318.67
|
| Rate for Payer: BCBS Complete |
$475.60
|
| Rate for Payer: BCBS MAPPO |
$306.41
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.73
|
| 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 Cigna Priority Health |
$772.85
|
| Rate for Payer: Priority Health Medicare |
$309.47
|
| 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
|
|
|
PR TRACHEOSTOMY FENESTRATION W/SKIN FLAPS
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 31610
|
| Min. Negotiated Rate |
$619.60 |
| Max. Negotiated Rate |
$1,289.68 |
| Rate for Payer: Aetna Commercial |
$1,200.12
|
| Rate for Payer: Aetna Medicare |
$931.43
|
| Rate for Payer: BCBS Complete |
$619.60
|
| Rate for Payer: BCBS MAPPO |
$895.61
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$940.39
|
| 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 Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health Medicare |
$904.57
|
| 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
|
|
|
PR TRACHEOSTOMY PLANNED SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 31600
|
| Min. Negotiated Rate |
$292.39 |
| Max. Negotiated Rate |
$682.50 |
| Rate for Payer: Aetna Commercial |
$391.80
|
| Rate for Payer: Aetna Medicare |
$304.09
|
| Rate for Payer: BCBS Complete |
$420.00
|
| Rate for Payer: BCBS MAPPO |
$292.39
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.01
|
| 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 Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health Medicare |
$295.31
|
| 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
|
|
|
PR TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 31601
|
| Min. Negotiated Rate |
$415.20 |
| Max. Negotiated Rate |
$674.70 |
| Rate for Payer: Aetna Commercial |
$574.74
|
| Rate for Payer: Aetna Medicare |
$446.07
|
| Rate for Payer: BCBS Complete |
$415.20
|
| Rate for Payer: BCBS MAPPO |
$428.91
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.36
|
| 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 Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health Medicare |
$433.20
|
| 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
|
|
|
PR TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 31502
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$47.45 |
| Rate for Payer: Aetna Commercial |
$44.09
|
| Rate for Payer: Aetna Medicare |
$34.22
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$32.90
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.55
|
| 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 Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Medicare |
$33.23
|
| 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
|
|
|
PR TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I
|
Professional
|
Both
|
$1,385.00
|
|
|
Service Code
|
HCPCS 34712
|
| Min. Negotiated Rate |
$554.00 |
| Max. Negotiated Rate |
$900.76 |
| Rate for Payer: Aetna Commercial |
$838.21
|
| Rate for Payer: Aetna Medicare |
$650.55
|
| Rate for Payer: BCBS Complete |
$554.00
|
| Rate for Payer: BCBS MAPPO |
$625.53
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.81
|
| 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 Cigna Priority Health |
$900.25
|
| Rate for Payer: Priority Health Medicare |
$631.79
|
| 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
|
|
|
PR TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE
|
Professional
|
Both
|
$5,665.00
|
|
|
Service Code
|
HCPCS 33366
|
| Min. Negotiated Rate |
$1,500.62 |
| 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 |
$2,266.00
|
| Rate for Payer: BCBS MAPPO |
$1,500.62
|
| 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 |
$2,010.83
|
| Rate for Payer: Cofinity Commercial |
$2,160.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,500.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,575.65
|
| 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 Cigna Priority Health |
$3,682.25
|
| Rate for Payer: Priority Health Medicare |
$1,515.63
|
| 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
|
|
|
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
|
|
|
PR TRANSCATH RX INFUSE OTHER
|
Professional
|
Both
|
$1,639.00
|
|
|
Service Code
|
HCPCS 37202
|
| Min. Negotiated Rate |
$655.60 |
| Max. Negotiated Rate |
$1,065.35 |
| Rate for Payer: Aetna Medicare |
$819.50
|
| Rate for Payer: BCBS Complete |
$655.60
|
| Rate for Payer: Cash Price |
$1,311.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.35
|
|
|
PR TRANSCATH STENT EACH ADDN VESSL,PERC
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 37206
|
| Min. Negotiated Rate |
$371.20 |
| Max. Negotiated Rate |
$603.20 |
| Rate for Payer: Aetna Medicare |
$464.00
|
| Rate for Payer: BCBS Complete |
$371.20
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.20
|
|
|
PR TRANSCATH STENT INIT VESSEL,PERCUT
|
Professional
|
Both
|
$1,719.00
|
|
|
Service Code
|
HCPCS 37205
|
| Min. Negotiated Rate |
$687.60 |
| Max. Negotiated Rate |
$1,117.35 |
| Rate for Payer: Aetna Medicare |
$859.50
|
| Rate for Payer: BCBS Complete |
$687.60
|
| Rate for Payer: Cash Price |
$1,375.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,117.35
|
|
|
PR TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART
|
Professional
|
Both
|
$4,519.00
|
|
|
Service Code
|
HCPCS 61596
|
| Min. Negotiated Rate |
$1,807.60 |
| Max. Negotiated Rate |
$3,328.83 |
| Rate for Payer: Aetna Commercial |
$3,097.66
|
| Rate for Payer: Aetna Medicare |
$2,404.16
|
| Rate for Payer: BCBS Complete |
$1,807.60
|
| Rate for Payer: BCBS MAPPO |
$2,311.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,311.69
|
| Rate for Payer: Cash Price |
$3,615.20
|
| Rate for Payer: Cash Price |
$3,615.20
|
| Rate for Payer: Cofinity Commercial |
$3,097.66
|
| Rate for Payer: Cofinity Commercial |
$3,328.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,311.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,427.27
|
| Rate for Payer: Nomi Health Commercial |
$2,774.03
|
| Rate for Payer: PACE SWMI |
$2,311.69
|
| Rate for Payer: PHP Medicare Advantage |
$2,311.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,937.35
|
| Rate for Payer: Priority Health Medicare |
$2,334.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,311.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,311.69
|
| Rate for Payer: UHC Exchange |
$2,311.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,311.69
|
|
|
PR TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 93892
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$378.00 |
| Rate for Payer: Aetna Commercial |
$351.75
|
| Rate for Payer: Aetna Medicare |
$273.00
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS MAPPO |
$262.50
|
| Rate for Payer: BCN Medicare Advantage |
$262.50
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$378.00
|
| Rate for Payer: Cofinity Commercial |
$351.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.62
|
| Rate for Payer: Nomi Health Commercial |
$315.00
|
| Rate for Payer: PACE SWMI |
$262.50
|
| Rate for Payer: PHP Medicare Advantage |
$262.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.95
|
| Rate for Payer: Priority Health Medicare |
$265.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.50
|
| Rate for Payer: UHC Exchange |
$262.50
|
| Rate for Payer: UHC Medicare Advantage |
$262.50
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
HCPCS 93886
|
| Min. Negotiated Rate |
$229.50 |
| Max. Negotiated Rate |
$410.80 |
| Rate for Payer: Aetna Commercial |
$307.53
|
| Rate for Payer: Aetna Commercial |
$307.53
|
| Rate for Payer: Aetna Medicare |
$238.68
|
| Rate for Payer: Aetna Medicare |
$238.68
|
| Rate for Payer: BCBS Complete |
$252.80
|
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: BCBS MAPPO |
$229.50
|
| Rate for Payer: BCBS MAPPO |
$229.50
|
| Rate for Payer: BCN Medicare Advantage |
$229.50
|
| Rate for Payer: BCN Medicare Advantage |
$229.50
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cofinity Commercial |
$330.48
|
| Rate for Payer: Cofinity Commercial |
$330.48
|
| Rate for Payer: Cofinity Commercial |
$307.53
|
| Rate for Payer: Cofinity Commercial |
$307.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$275.40
|
| Rate for Payer: Nomi Health Commercial |
$275.40
|
| Rate for Payer: PACE SWMI |
$229.50
|
| Rate for Payer: PACE SWMI |
$229.50
|
| Rate for Payer: PHP Medicare Advantage |
$229.50
|
| Rate for Payer: PHP Medicare Advantage |
$229.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.80
|
| Rate for Payer: Priority Health Medicare |
$231.79
|
| Rate for Payer: Priority Health Medicare |
$231.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.50
|
| Rate for Payer: UHC Exchange |
$229.50
|
| Rate for Payer: UHC Exchange |
$229.50
|
| Rate for Payer: UHC Medicare Advantage |
$229.50
|
| Rate for Payer: UHC Medicare Advantage |
$229.50
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 93888
|
| Min. Negotiated Rate |
$144.94 |
| Max. Negotiated Rate |
$239.20 |
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: Aetna Medicare |
$150.74
|
| Rate for Payer: BCBS Complete |
$147.20
|
| Rate for Payer: BCBS MAPPO |
$144.94
|
| Rate for Payer: BCN Medicare Advantage |
$144.94
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$208.71
|
| Rate for Payer: Cofinity Commercial |
$194.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.19
|
| Rate for Payer: Nomi Health Commercial |
$173.93
|
| Rate for Payer: PACE SWMI |
$144.94
|
| Rate for Payer: PHP Medicare Advantage |
$144.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.20
|
| Rate for Payer: Priority Health Medicare |
$146.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.94
|
| Rate for Payer: UHC Exchange |
$144.94
|
| Rate for Payer: UHC Medicare Advantage |
$144.94
|
|
|
PR TRANSECTION/AVULSION GREATER OCCIPITAL NERVE
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 64744
|
| Min. Negotiated Rate |
$346.80 |
| Max. Negotiated Rate |
$717.21 |
| Rate for Payer: Aetna Commercial |
$667.40
|
| Rate for Payer: Aetna Medicare |
$517.98
|
| Rate for Payer: BCBS Complete |
$346.80
|
| Rate for Payer: BCBS MAPPO |
$498.06
|
| Rate for Payer: BCN Medicare Advantage |
$498.06
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$717.21
|
| Rate for Payer: Cofinity Commercial |
$667.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$522.96
|
| Rate for Payer: Nomi Health Commercial |
$597.67
|
| Rate for Payer: PACE SWMI |
$498.06
|
| Rate for Payer: PHP Medicare Advantage |
$498.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health Medicare |
$503.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$498.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.06
|
| Rate for Payer: UHC Exchange |
$498.06
|
| Rate for Payer: UHC Medicare Advantage |
$498.06
|
|
|
PR TRANSECTION/AVULSION OTH SPINAL NRV XDRL
|
Professional
|
Both
|
$1,307.00
|
|
|
Service Code
|
HCPCS 64772
|
| Min. Negotiated Rate |
$522.80 |
| Max. Negotiated Rate |
$849.55 |
| Rate for Payer: Aetna Commercial |
$718.49
|
| Rate for Payer: Aetna Medicare |
$557.64
|
| Rate for Payer: BCBS Complete |
$522.80
|
| Rate for Payer: BCBS MAPPO |
$536.19
|
| Rate for Payer: BCN Medicare Advantage |
$536.19
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cofinity Commercial |
$772.11
|
| Rate for Payer: Cofinity Commercial |
$718.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.00
|
| Rate for Payer: Nomi Health Commercial |
$643.43
|
| Rate for Payer: PACE SWMI |
$536.19
|
| Rate for Payer: PHP Medicare Advantage |
$536.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$849.55
|
| Rate for Payer: Priority Health Medicare |
$541.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$536.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.19
|
| Rate for Payer: UHC Exchange |
$536.19
|
| Rate for Payer: UHC Medicare Advantage |
$536.19
|
|
