|
PR TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART
|
Professional
|
Both
|
$1,756.00
|
|
|
Service Code
|
HCPCS 35693
|
| Min. Negotiated Rate |
$702.40 |
| Max. Negotiated Rate |
$1,160.42 |
| Rate for Payer: Aetna Commercial |
$1,079.84
|
| Rate for Payer: Aetna Medicare |
$838.08
|
| Rate for Payer: BCBS Complete |
$702.40
|
| Rate for Payer: BCBS MAPPO |
$805.85
|
| Rate for Payer: BCN Medicare Advantage |
$805.85
|
| Rate for Payer: Cash Price |
$1,404.80
|
| Rate for Payer: Cash Price |
$1,404.80
|
| Rate for Payer: Cofinity Commercial |
$1,160.42
|
| Rate for Payer: Cofinity Commercial |
$1,079.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$846.14
|
| Rate for Payer: Nomi Health Commercial |
$967.02
|
| Rate for Payer: PACE SWMI |
$805.85
|
| Rate for Payer: PHP Medicare Advantage |
$805.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.40
|
| Rate for Payer: Priority Health Medicare |
$813.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$805.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$805.85
|
| Rate for Payer: UHC Exchange |
$805.85
|
| Rate for Payer: UHC Medicare Advantage |
$805.85
|
|
|
PR TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 26497
|
| Min. Negotiated Rate |
$853.26 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$1,143.37
|
| Rate for Payer: Aetna Medicare |
$887.39
|
| Rate for Payer: BCBS Complete |
$1,110.00
|
| Rate for Payer: BCBS MAPPO |
$853.26
|
| Rate for Payer: BCN Medicare Advantage |
$853.26
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cofinity Commercial |
$1,228.69
|
| Rate for Payer: Cofinity Commercial |
$1,143.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.92
|
| Rate for Payer: Nomi Health Commercial |
$1,023.91
|
| Rate for Payer: PACE SWMI |
$853.26
|
| Rate for Payer: PHP Medicare Advantage |
$853.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.75
|
| Rate for Payer: Priority Health Medicare |
$861.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$853.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$853.26
|
| Rate for Payer: UHC Exchange |
$853.26
|
| Rate for Payer: UHC Medicare Advantage |
$853.26
|
|
|
PR TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND
|
Professional
|
Both
|
$5,615.00
|
|
|
Service Code
|
HCPCS 26551
|
| Min. Negotiated Rate |
$2,246.00 |
| Max. Negotiated Rate |
$4,528.89 |
| Rate for Payer: Aetna Commercial |
$4,214.38
|
| Rate for Payer: Aetna Medicare |
$3,270.86
|
| Rate for Payer: BCBS Complete |
$2,246.00
|
| Rate for Payer: BCBS MAPPO |
$3,145.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,145.06
|
| Rate for Payer: Cash Price |
$4,492.00
|
| Rate for Payer: Cash Price |
$4,492.00
|
| Rate for Payer: Cofinity Commercial |
$4,528.89
|
| Rate for Payer: Cofinity Commercial |
$4,214.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,145.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,302.31
|
| Rate for Payer: Nomi Health Commercial |
$3,774.07
|
| Rate for Payer: PACE SWMI |
$3,145.06
|
| Rate for Payer: PHP Medicare Advantage |
$3,145.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,649.75
|
| Rate for Payer: Priority Health Medicare |
$3,176.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,145.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,145.06
|
| Rate for Payer: UHC Exchange |
$3,145.06
|
| Rate for Payer: UHC Medicare Advantage |
$3,145.06
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP
|
Professional
|
Both
|
$2,819.00
|
|
|
Service Code
|
HCPCS 27691
|
| Min. Negotiated Rate |
$714.66 |
| Max. Negotiated Rate |
$1,832.35 |
| Rate for Payer: Aetna Commercial |
$957.64
|
| Rate for Payer: Aetna Medicare |
$743.25
|
| Rate for Payer: BCBS Complete |
$1,127.60
|
| Rate for Payer: BCBS MAPPO |
$714.66
|
| Rate for Payer: BCN Medicare Advantage |
$714.66
|
| Rate for Payer: Cash Price |
$2,255.20
|
| Rate for Payer: Cash Price |
$2,255.20
|
| Rate for Payer: Cofinity Commercial |
$957.64
|
| Rate for Payer: Cofinity Commercial |
$1,029.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$750.39
|
| Rate for Payer: Nomi Health Commercial |
$857.59
|
| Rate for Payer: PACE SWMI |
$714.66
|
| Rate for Payer: PHP Medicare Advantage |
$714.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,832.35
|
| Rate for Payer: Priority Health Medicare |
$721.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$714.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$714.66
|
| Rate for Payer: UHC Exchange |
$714.66
|
| Rate for Payer: UHC Medicare Advantage |
$714.66
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 27692
|
| Min. Negotiated Rate |
$98.65 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Aetna Commercial |
$132.19
|
| Rate for Payer: Aetna Medicare |
$102.60
|
| Rate for Payer: BCBS Complete |
$204.00
|
| Rate for Payer: BCBS MAPPO |
$98.65
|
| Rate for Payer: BCN Medicare Advantage |
$98.65
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$142.06
|
| Rate for Payer: Cofinity Commercial |
$132.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.58
|
| Rate for Payer: Nomi Health Commercial |
$118.38
|
| Rate for Payer: PACE SWMI |
$98.65
|
| Rate for Payer: PHP Medicare Advantage |
$98.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
| Rate for Payer: Priority Health Medicare |
$99.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.65
|
| Rate for Payer: UHC Exchange |
$98.65
|
| Rate for Payer: UHC Medicare Advantage |
$98.65
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC
|
Professional
|
Both
|
$1,995.00
|
|
|
Service Code
|
HCPCS 27690
|
| Min. Negotiated Rate |
$613.89 |
| Max. Negotiated Rate |
$1,296.75 |
| Rate for Payer: Aetna Commercial |
$822.61
|
| Rate for Payer: Aetna Medicare |
$638.45
|
| Rate for Payer: BCBS Complete |
$798.00
|
| Rate for Payer: BCBS MAPPO |
$613.89
|
| Rate for Payer: BCN Medicare Advantage |
$613.89
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cofinity Commercial |
$884.00
|
| Rate for Payer: Cofinity Commercial |
$822.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$613.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$644.58
|
| Rate for Payer: Nomi Health Commercial |
$736.67
|
| Rate for Payer: PACE SWMI |
$613.89
|
| Rate for Payer: PHP Medicare Advantage |
$613.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.75
|
| Rate for Payer: Priority Health Medicare |
$620.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$613.89
|
| Rate for Payer: UHC Exchange |
$613.89
|
| Rate for Payer: UHC Medicare Advantage |
$613.89
|
|
|
PR TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN
|
Professional
|
Both
|
$2,062.00
|
|
|
Service Code
|
HCPCS 26480
|
| Min. Negotiated Rate |
$687.64 |
| Max. Negotiated Rate |
$1,340.30 |
| Rate for Payer: Aetna Commercial |
$921.44
|
| Rate for Payer: Aetna Medicare |
$715.15
|
| Rate for Payer: BCBS Complete |
$824.80
|
| Rate for Payer: BCBS MAPPO |
$687.64
|
| Rate for Payer: BCN Medicare Advantage |
$687.64
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$990.20
|
| Rate for Payer: Cofinity Commercial |
$921.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.02
|
| Rate for Payer: Nomi Health Commercial |
$825.17
|
| Rate for Payer: PACE SWMI |
$687.64
|
| Rate for Payer: PHP Medicare Advantage |
$687.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.30
|
| Rate for Payer: Priority Health Medicare |
$694.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$687.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$687.64
|
| Rate for Payer: UHC Exchange |
$687.64
|
| Rate for Payer: UHC Medicare Advantage |
$687.64
|
|
|
PR TRURL DRAINAGE PROSTATIC ABSCESS
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 52700
|
| Min. Negotiated Rate |
$330.80 |
| Max. Negotiated Rate |
$609.67 |
| Rate for Payer: Aetna Commercial |
$567.33
|
| Rate for Payer: Aetna Medicare |
$440.32
|
| Rate for Payer: BCBS Complete |
$330.80
|
| Rate for Payer: BCBS MAPPO |
$423.38
|
| Rate for Payer: BCN Medicare Advantage |
$423.38
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$609.67
|
| Rate for Payer: Cofinity Commercial |
$567.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$423.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$444.55
|
| Rate for Payer: Nomi Health Commercial |
$508.06
|
| Rate for Payer: PACE SWMI |
$423.38
|
| Rate for Payer: PHP Medicare Advantage |
$423.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.55
|
| Rate for Payer: Priority Health Medicare |
$427.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$423.38
|
| Rate for Payer: UHC Exchange |
$423.38
|
| Rate for Payer: UHC Medicare Advantage |
$423.38
|
|
|
PR TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY
|
Professional
|
Both
|
$3,550.00
|
|
|
Service Code
|
HCPCS 53854
|
| Min. Negotiated Rate |
$363.73 |
| Max. Negotiated Rate |
$2,307.50 |
| Rate for Payer: Aetna Commercial |
$487.40
|
| Rate for Payer: Aetna Medicare |
$378.28
|
| Rate for Payer: BCBS Complete |
$1,420.00
|
| Rate for Payer: BCBS MAPPO |
$363.73
|
| Rate for Payer: BCN Medicare Advantage |
$363.73
|
| Rate for Payer: Cash Price |
$2,840.00
|
| Rate for Payer: Cash Price |
$2,840.00
|
| Rate for Payer: Cofinity Commercial |
$523.77
|
| Rate for Payer: Cofinity Commercial |
$487.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.92
|
| Rate for Payer: Nomi Health Commercial |
$436.48
|
| Rate for Payer: PACE SWMI |
$363.73
|
| Rate for Payer: PHP Medicare Advantage |
$363.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,307.50
|
| Rate for Payer: Priority Health Medicare |
$367.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.73
|
| Rate for Payer: UHC Exchange |
$363.73
|
| Rate for Payer: UHC Medicare Advantage |
$363.73
|
|
|
PR TRURL DSTRJ PRSTATE TISS RF THERMOTH
|
Professional
|
Both
|
$2,935.00
|
|
|
Service Code
|
HCPCS 53852
|
| Min. Negotiated Rate |
$363.73 |
| Max. Negotiated Rate |
$1,907.75 |
| Rate for Payer: Aetna Commercial |
$487.40
|
| Rate for Payer: Aetna Medicare |
$378.28
|
| Rate for Payer: BCBS Complete |
$1,174.00
|
| Rate for Payer: BCBS MAPPO |
$363.73
|
| Rate for Payer: BCN Medicare Advantage |
$363.73
|
| Rate for Payer: Cash Price |
$2,348.00
|
| Rate for Payer: Cash Price |
$2,348.00
|
| Rate for Payer: Cofinity Commercial |
$523.77
|
| Rate for Payer: Cofinity Commercial |
$487.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.92
|
| Rate for Payer: Nomi Health Commercial |
$436.48
|
| Rate for Payer: PACE SWMI |
$363.73
|
| Rate for Payer: PHP Medicare Advantage |
$363.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,907.75
|
| Rate for Payer: Priority Health Medicare |
$367.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.73
|
| Rate for Payer: UHC Exchange |
$363.73
|
| Rate for Payer: UHC Medicare Advantage |
$363.73
|
|
|
PR TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE
|
Professional
|
Both
|
$1,590.00
|
|
|
Service Code
|
HCPCS 52601
|
| Min. Negotiated Rate |
$636.00 |
| Max. Negotiated Rate |
$1,033.50 |
| Rate for Payer: Aetna Commercial |
$932.00
|
| Rate for Payer: Aetna Medicare |
$723.34
|
| Rate for Payer: BCBS Complete |
$636.00
|
| Rate for Payer: BCBS MAPPO |
$695.52
|
| Rate for Payer: BCN Medicare Advantage |
$695.52
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$1,001.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.30
|
| Rate for Payer: Nomi Health Commercial |
$834.62
|
| Rate for Payer: PACE SWMI |
$695.52
|
| Rate for Payer: PHP Medicare Advantage |
$695.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,033.50
|
| Rate for Payer: Priority Health Medicare |
$702.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.52
|
| Rate for Payer: UHC Exchange |
$695.52
|
| Rate for Payer: UHC Medicare Advantage |
$695.52
|
|
|
PR TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE
|
Professional
|
Both
|
$724.00
|
|
|
Service Code
|
HCPCS 52640
|
| Min. Negotiated Rate |
$289.60 |
| Max. Negotiated Rate |
$470.60 |
| Rate for Payer: Aetna Commercial |
$413.73
|
| Rate for Payer: Aetna Medicare |
$321.10
|
| Rate for Payer: BCBS Complete |
$289.60
|
| Rate for Payer: BCBS MAPPO |
$308.75
|
| Rate for Payer: BCN Medicare Advantage |
$308.75
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$444.60
|
| Rate for Payer: Cofinity Commercial |
$413.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.19
|
| Rate for Payer: Nomi Health Commercial |
$370.50
|
| Rate for Payer: PACE SWMI |
$308.75
|
| Rate for Payer: PHP Medicare Advantage |
$308.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.60
|
| Rate for Payer: Priority Health Medicare |
$311.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.75
|
| Rate for Payer: UHC Exchange |
$308.75
|
| Rate for Payer: UHC Medicare Advantage |
$308.75
|
|
|
PR TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 52630
|
| Min. Negotiated Rate |
$315.60 |
| Max. Negotiated Rate |
$559.27 |
| Rate for Payer: Aetna Commercial |
$520.43
|
| Rate for Payer: Aetna Medicare |
$403.92
|
| Rate for Payer: BCBS Complete |
$315.60
|
| Rate for Payer: BCBS MAPPO |
$388.38
|
| Rate for Payer: BCN Medicare Advantage |
$388.38
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$559.27
|
| Rate for Payer: Cofinity Commercial |
$520.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.80
|
| Rate for Payer: Nomi Health Commercial |
$466.06
|
| Rate for Payer: PACE SWMI |
$388.38
|
| Rate for Payer: PHP Medicare Advantage |
$388.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health Medicare |
$392.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$388.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$388.38
|
| Rate for Payer: UHC Exchange |
$388.38
|
| Rate for Payer: UHC Medicare Advantage |
$388.38
|
|
|
PR TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP
|
Professional
|
Both
|
$154.00
|
|
|
Service Code
|
HCPCS 95921
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$114.12 |
| Rate for Payer: Aetna Commercial |
$106.19
|
| Rate for Payer: Aetna Medicare |
$82.42
|
| Rate for Payer: BCBS Complete |
$61.60
|
| Rate for Payer: BCBS MAPPO |
$79.25
|
| Rate for Payer: BCN Medicare Advantage |
$79.25
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cofinity Commercial |
$114.12
|
| Rate for Payer: Cofinity Commercial |
$106.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.21
|
| Rate for Payer: Nomi Health Commercial |
$95.10
|
| Rate for Payer: PACE SWMI |
$79.25
|
| Rate for Payer: PHP Medicare Advantage |
$79.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
| Rate for Payer: Priority Health Medicare |
$80.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.25
|
| Rate for Payer: UHC Exchange |
$79.25
|
| Rate for Payer: UHC Medicare Advantage |
$79.25
|
|
|
PR TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 95924
|
| Min. Negotiated Rate |
$72.40 |
| Max. Negotiated Rate |
$195.52 |
| Rate for Payer: Aetna Commercial |
$181.95
|
| Rate for Payer: Aetna Medicare |
$141.21
|
| Rate for Payer: BCBS Complete |
$72.40
|
| Rate for Payer: BCBS MAPPO |
$135.78
|
| Rate for Payer: BCN Medicare Advantage |
$135.78
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$195.52
|
| Rate for Payer: Cofinity Commercial |
$181.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.57
|
| Rate for Payer: Nomi Health Commercial |
$162.94
|
| Rate for Payer: PACE SWMI |
$135.78
|
| Rate for Payer: PHP Medicare Advantage |
$135.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health Medicare |
$137.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.78
|
| Rate for Payer: UHC Exchange |
$135.78
|
| Rate for Payer: UHC Medicare Advantage |
$135.78
|
|
|
PR TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 95922
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$120.25 |
| Rate for Payer: Aetna Commercial |
$109.42
|
| Rate for Payer: Aetna Medicare |
$84.93
|
| Rate for Payer: BCBS Complete |
$74.00
|
| Rate for Payer: BCBS MAPPO |
$81.66
|
| Rate for Payer: BCN Medicare Advantage |
$81.66
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$117.59
|
| Rate for Payer: Cofinity Commercial |
$109.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.74
|
| Rate for Payer: Nomi Health Commercial |
$97.99
|
| Rate for Payer: PACE SWMI |
$81.66
|
| Rate for Payer: PHP Medicare Advantage |
$81.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health Medicare |
$82.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.66
|
| Rate for Payer: UHC Exchange |
$81.66
|
| Rate for Payer: UHC Medicare Advantage |
$81.66
|
|
|
PR TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 31730
|
| Min. Negotiated Rate |
$122.00 |
| Max. Negotiated Rate |
$207.96 |
| Rate for Payer: Aetna Commercial |
$193.52
|
| Rate for Payer: Aetna Medicare |
$150.20
|
| Rate for Payer: BCBS Complete |
$122.00
|
| Rate for Payer: BCBS MAPPO |
$144.42
|
| Rate for Payer: BCN Medicare Advantage |
$144.42
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$207.96
|
| Rate for Payer: Cofinity Commercial |
$193.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.64
|
| Rate for Payer: Nomi Health Commercial |
$173.30
|
| Rate for Payer: PACE SWMI |
$144.42
|
| Rate for Payer: PHP Medicare Advantage |
$144.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health Medicare |
$145.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.42
|
| Rate for Payer: UHC Exchange |
$144.42
|
| Rate for Payer: UHC Medicare Advantage |
$144.42
|
|
|
PR TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD
|
Professional
|
Both
|
$1,243.00
|
|
|
Service Code
|
HCPCS 44015
|
| Min. Negotiated Rate |
$136.65 |
| Max. Negotiated Rate |
$807.95 |
| Rate for Payer: Aetna Commercial |
$183.11
|
| Rate for Payer: Aetna Medicare |
$142.12
|
| Rate for Payer: BCBS Complete |
$497.20
|
| Rate for Payer: BCBS MAPPO |
$136.65
|
| Rate for Payer: BCN Medicare Advantage |
$136.65
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cofinity Commercial |
$196.78
|
| Rate for Payer: Cofinity Commercial |
$183.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.48
|
| Rate for Payer: Nomi Health Commercial |
$163.98
|
| Rate for Payer: PACE SWMI |
$136.65
|
| Rate for Payer: PHP Medicare Advantage |
$136.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.95
|
| Rate for Payer: Priority Health Medicare |
$138.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.65
|
| Rate for Payer: UHC Exchange |
$136.65
|
| Rate for Payer: UHC Medicare Advantage |
$136.65
|
|
|
PR TUBE THORACOSTOMY INCLUDES WATER SEAL
|
Professional
|
Both
|
$602.00
|
|
|
Service Code
|
HCPCS 32551
|
| Min. Negotiated Rate |
$149.09 |
| Max. Negotiated Rate |
$391.30 |
| Rate for Payer: Aetna Commercial |
$199.78
|
| Rate for Payer: Aetna Medicare |
$155.05
|
| Rate for Payer: BCBS Complete |
$240.80
|
| Rate for Payer: BCBS MAPPO |
$149.09
|
| Rate for Payer: BCN Medicare Advantage |
$149.09
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cofinity Commercial |
$214.69
|
| Rate for Payer: Cofinity Commercial |
$199.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.54
|
| Rate for Payer: Nomi Health Commercial |
$178.91
|
| Rate for Payer: PACE SWMI |
$149.09
|
| Rate for Payer: PHP Medicare Advantage |
$149.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.30
|
| Rate for Payer: Priority Health Medicare |
$150.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.09
|
| Rate for Payer: UHC Exchange |
$149.09
|
| Rate for Payer: UHC Medicare Advantage |
$149.09
|
|
|
PR TUBOTUBAL ANASTATOMOSIS
|
Professional
|
Both
|
$1,653.00
|
|
|
Service Code
|
HCPCS 58750
|
| Min. Negotiated Rate |
$661.20 |
| Max. Negotiated Rate |
$1,258.33 |
| Rate for Payer: Aetna Commercial |
$1,170.95
|
| Rate for Payer: Aetna Medicare |
$908.79
|
| Rate for Payer: BCBS Complete |
$661.20
|
| Rate for Payer: BCBS MAPPO |
$873.84
|
| Rate for Payer: BCN Medicare Advantage |
$873.84
|
| Rate for Payer: Cash Price |
$1,322.40
|
| Rate for Payer: Cash Price |
$1,322.40
|
| Rate for Payer: Cofinity Commercial |
$1,258.33
|
| Rate for Payer: Cofinity Commercial |
$1,170.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$873.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$917.53
|
| Rate for Payer: Nomi Health Commercial |
$1,048.61
|
| Rate for Payer: PACE SWMI |
$873.84
|
| Rate for Payer: PHP Medicare Advantage |
$873.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,074.45
|
| Rate for Payer: Priority Health Medicare |
$882.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$873.84
|
| Rate for Payer: UHC Exchange |
$873.84
|
| Rate for Payer: UHC Medicare Advantage |
$873.84
|
|
|
PR TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA
|
Professional
|
Both
|
$3,910.00
|
|
|
Service Code
|
HCPCS 61108
|
| Min. Negotiated Rate |
$895.06 |
| Max. Negotiated Rate |
$2,541.50 |
| Rate for Payer: Aetna Commercial |
$1,199.38
|
| Rate for Payer: Aetna Medicare |
$930.86
|
| Rate for Payer: BCBS Complete |
$1,564.00
|
| Rate for Payer: BCBS MAPPO |
$895.06
|
| Rate for Payer: BCN Medicare Advantage |
$895.06
|
| Rate for Payer: Cash Price |
$3,128.00
|
| Rate for Payer: Cash Price |
$3,128.00
|
| Rate for Payer: Cofinity Commercial |
$1,288.89
|
| Rate for Payer: Cofinity Commercial |
$1,199.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$895.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$939.81
|
| Rate for Payer: Nomi Health Commercial |
$1,074.07
|
| Rate for Payer: PACE SWMI |
$895.06
|
| Rate for Payer: PHP Medicare Advantage |
$895.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,541.50
|
| Rate for Payer: Priority Health Medicare |
$904.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$895.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$895.06
|
| Rate for Payer: UHC Exchange |
$895.06
|
| Rate for Payer: UHC Medicare Advantage |
$895.06
|
|
|
PR TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Professional
|
Both
|
$2,479.00
|
|
|
Service Code
|
HCPCS 61107
|
| Min. Negotiated Rate |
$309.66 |
| Max. Negotiated Rate |
$1,611.35 |
| Rate for Payer: Aetna Commercial |
$414.94
|
| Rate for Payer: Aetna Medicare |
$322.05
|
| Rate for Payer: BCBS Complete |
$991.60
|
| Rate for Payer: BCBS MAPPO |
$309.66
|
| Rate for Payer: BCN Medicare Advantage |
$309.66
|
| Rate for Payer: Cash Price |
$1,983.20
|
| Rate for Payer: Cash Price |
$1,983.20
|
| Rate for Payer: Cofinity Commercial |
$445.91
|
| Rate for Payer: Cofinity Commercial |
$414.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.14
|
| Rate for Payer: Nomi Health Commercial |
$371.59
|
| Rate for Payer: PACE SWMI |
$309.66
|
| Rate for Payer: PHP Medicare Advantage |
$309.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,611.35
|
| Rate for Payer: Priority Health Medicare |
$312.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.66
|
| Rate for Payer: UHC Exchange |
$309.66
|
| Rate for Payer: UHC Medicare Advantage |
$309.66
|
|
|
PR TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE
|
Professional
|
Both
|
$2,149.00
|
|
|
Service Code
|
HCPCS 61105
|
| Min. Negotiated Rate |
$459.60 |
| Max. Negotiated Rate |
$1,396.85 |
| Rate for Payer: Aetna Commercial |
$615.86
|
| Rate for Payer: Aetna Medicare |
$477.98
|
| Rate for Payer: BCBS Complete |
$859.60
|
| Rate for Payer: BCBS MAPPO |
$459.60
|
| Rate for Payer: BCN Medicare Advantage |
$459.60
|
| Rate for Payer: Cash Price |
$1,719.20
|
| Rate for Payer: Cash Price |
$1,719.20
|
| Rate for Payer: Cofinity Commercial |
$661.82
|
| Rate for Payer: Cofinity Commercial |
$615.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$459.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$482.58
|
| Rate for Payer: Nomi Health Commercial |
$551.52
|
| Rate for Payer: PACE SWMI |
$459.60
|
| Rate for Payer: PHP Medicare Advantage |
$459.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.85
|
| Rate for Payer: Priority Health Medicare |
$464.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$459.60
|
| Rate for Payer: UHC Exchange |
$459.60
|
| Rate for Payer: UHC Medicare Advantage |
$459.60
|
|
|
PR TWO AREA LIPOSUCTION - 2 AREA 2.0 HR
|
Professional
|
Both
|
$2,754.00
|
|
|
Service Code
|
HCPCS 00528
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,101.60 |
| Max. Negotiated Rate |
$1,790.10 |
| Rate for Payer: Aetna Medicare |
$1,377.00
|
| Rate for Payer: BCBS Complete |
$1,101.60
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,790.10
|
|
|
PR TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON
|
Professional
|
Both
|
$1,465.00
|
|
|
Service Code
|
HCPCS 46280
|
| Min. Negotiated Rate |
$460.26 |
| Max. Negotiated Rate |
$952.25 |
| Rate for Payer: Aetna Commercial |
$616.75
|
| Rate for Payer: Aetna Medicare |
$478.67
|
| Rate for Payer: BCBS Complete |
$586.00
|
| Rate for Payer: BCBS MAPPO |
$460.26
|
| Rate for Payer: BCN Medicare Advantage |
$460.26
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cofinity Commercial |
$662.77
|
| Rate for Payer: Cofinity Commercial |
$616.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.27
|
| Rate for Payer: Nomi Health Commercial |
$552.31
|
| Rate for Payer: PACE SWMI |
$460.26
|
| Rate for Payer: PHP Medicare Advantage |
$460.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.25
|
| Rate for Payer: Priority Health Medicare |
$464.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$460.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$460.26
|
| Rate for Payer: UHC Exchange |
$460.26
|
| Rate for Payer: UHC Medicare Advantage |
$460.26
|
|
