|
PR REINSERTION SPINAL FIXATION DEVICE
|
Professional
|
Both
|
$4,902.00
|
|
|
Service Code
|
HCPCS 22849
|
| Min. Negotiated Rate |
$136.69 |
| Max. Negotiated Rate |
$3,431.40 |
| Rate for Payer: Aetna Commercial |
$1,754.05
|
| Rate for Payer: BCBS Complete |
$884.09
|
| Rate for Payer: BCBS Trust/PPO |
$136.69
|
| Rate for Payer: Cash Price |
$3,921.60
|
| Rate for Payer: Cash Price |
$3,921.60
|
| Rate for Payer: Meridian Medicaid |
$884.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,431.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,003.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,003.27
|
| Rate for Payer: Priority Health SBD |
$2,003.27
|
| Rate for Payer: UMR Bronson Commercial |
$2,254.92
|
|
|
PR RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE
|
Professional
|
Both
|
$1,023.00
|
|
|
Service Code
|
HCPCS 26593
|
| Min. Negotiated Rate |
$390.41 |
| Max. Negotiated Rate |
$1,003.93 |
| Rate for Payer: Aetna Commercial |
$849.31
|
| Rate for Payer: BCBS Complete |
$439.03
|
| Rate for Payer: BCBS Trust/PPO |
$390.41
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Meridian Medicaid |
$439.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.93
|
| Rate for Payer: Priority Health SBD |
$1,003.93
|
| Rate for Payer: UMR Bronson Commercial |
$470.58
|
|
|
PR RELEASE/RECESSION HAMSTRING PROXIMAL
|
Professional
|
Both
|
$2,280.00
|
|
|
Service Code
|
HCPCS 27097
|
| Min. Negotiated Rate |
$443.04 |
| Max. Negotiated Rate |
$1,596.00 |
| Rate for Payer: Aetna Commercial |
$911.61
|
| Rate for Payer: BCBS Complete |
$465.19
|
| Rate for Payer: BCBS Trust/PPO |
$828.90
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Meridian Medicaid |
$465.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,596.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,053.98
|
| Rate for Payer: Priority Health SBD |
$1,053.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,048.80
|
|
|
PR RELEASE TARSAL TUNNEL
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 28035
|
| Min. Negotiated Rate |
$184.38 |
| Max. Negotiated Rate |
$949.90 |
| Rate for Payer: Aetna Commercial |
$471.96
|
| Rate for Payer: BCBS Complete |
$243.11
|
| Rate for Payer: BCBS Trust/PPO |
$184.38
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Meridian Medicaid |
$243.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$949.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.93
|
| Rate for Payer: Priority Health Narrow Network |
$547.93
|
| Rate for Payer: Priority Health SBD |
$547.93
|
| Rate for Payer: UMR Bronson Commercial |
$624.22
|
|
|
PR RELEASE THENAR MUSCLE
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 26508
|
| Min. Negotiated Rate |
$439.21 |
| Max. Negotiated Rate |
$3,420.21 |
| Rate for Payer: Aetna Commercial |
$890.70
|
| Rate for Payer: BCBS Complete |
$461.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,420.21
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Meridian Medicaid |
$461.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,052.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,052.95
|
| Rate for Payer: Priority Health SBD |
$1,052.95
|
| Rate for Payer: UMR Bronson Commercial |
$715.30
|
|
|
PR RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR
|
Professional
|
Both
|
$1,330.00
|
|
|
Service Code
|
HCPCS 33223
|
| Min. Negotiated Rate |
$257.52 |
| Max. Negotiated Rate |
$1,195.54 |
| Rate for Payer: Aetna Commercial |
$550.24
|
| Rate for Payer: BCBS Complete |
$270.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,195.54
|
| Rate for Payer: Cash Price |
$1,064.00
|
| Rate for Payer: Cash Price |
$1,064.00
|
| Rate for Payer: Meridian Medicaid |
$270.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$257.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$931.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$645.26
|
| Rate for Payer: Priority Health Narrow Network |
$645.26
|
| Rate for Payer: Priority Health SBD |
$645.26
|
| Rate for Payer: UMR Bronson Commercial |
$611.80
|
|
|
PR RELOCATION OF SKIN POCKET FOR PACEMAKER
|
Professional
|
Both
|
$1,128.00
|
|
|
Service Code
|
HCPCS 33222
|
| Min. Negotiated Rate |
$216.83 |
| Max. Negotiated Rate |
$1,036.00 |
| Rate for Payer: Aetna Commercial |
$456.42
|
| Rate for Payer: BCBS Complete |
$227.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,036.00
|
| Rate for Payer: Cash Price |
$902.40
|
| Rate for Payer: Cash Price |
$902.40
|
| Rate for Payer: Meridian Medicaid |
$227.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$789.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$541.53
|
| Rate for Payer: Priority Health Narrow Network |
$541.53
|
| Rate for Payer: Priority Health SBD |
$541.53
|
| Rate for Payer: UMR Bronson Commercial |
$518.88
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 93297
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$1,891.84 |
| Rate for Payer: Aetna Commercial |
$35.35
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,891.84
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.93
|
| Rate for Payer: Priority Health Narrow Network |
$35.93
|
| Rate for Payer: Priority Health SBD |
$35.93
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
PR REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 93299
|
| Min. Negotiated Rate |
$90.80 |
| Max. Negotiated Rate |
$158.90 |
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.90
|
| Rate for Payer: UMR Bronson Commercial |
$104.42
|
|
|
PR REM INTERROG PM/LDLS PM <90 D PHYS/QHP
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 93294
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$1,440.67 |
| Rate for Payer: Aetna Commercial |
$40.41
|
| Rate for Payer: BCBS Complete |
$19.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,440.67
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Meridian Medicaid |
$19.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.61
|
| Rate for Payer: Priority Health Narrow Network |
$41.61
|
| Rate for Payer: Priority Health SBD |
$41.61
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
PR REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 93296
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$277.89 |
| Rate for Payer: Aetna Commercial |
$31.79
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$277.89
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.68
|
| Rate for Payer: Priority Health Narrow Network |
$31.68
|
| Rate for Payer: Priority Health SBD |
$31.68
|
| Rate for Payer: UMR Bronson Commercial |
$23.00
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93298
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$1,610.26 |
| Rate for Payer: Aetna Commercial |
$35.35
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.26
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.41
|
| Rate for Payer: Priority Health Narrow Network |
$36.41
|
| Rate for Payer: Priority Health SBD |
$36.41
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Professional
|
Both
|
$109.00
|
|
|
Service Code
|
HCPCS 99454
|
| Min. Negotiated Rate |
$43.60 |
| Max. Negotiated Rate |
$203.92 |
| Rate for Payer: Aetna Commercial |
$58.13
|
| Rate for Payer: BCBS Complete |
$43.60
|
| Rate for Payer: BCBS Trust/PPO |
$203.92
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.39
|
| Rate for Payer: Priority Health Narrow Network |
$63.39
|
| Rate for Payer: Priority Health SBD |
$63.39
|
| Rate for Payer: UMR Bronson Commercial |
$50.14
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 99453
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$1,867.54 |
| Rate for Payer: Aetna Commercial |
$17.68
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,867.54
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.42
|
| Rate for Payer: Priority Health Narrow Network |
$24.42
|
| Rate for Payer: Priority Health SBD |
$24.42
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
PR REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 93264
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$817.28 |
| Rate for Payer: Aetna Commercial |
$47.30
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS Trust/PPO |
$817.28
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.17
|
| Rate for Payer: Priority Health Narrow Network |
$49.17
|
| Rate for Payer: Priority Health SBD |
$49.17
|
| Rate for Payer: UMR Bronson Commercial |
$45.54
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING 1ST 20 MIN MONTH
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS 99457
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$278.41 |
| Rate for Payer: Aetna Commercial |
$31.23
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS Trust/PPO |
$278.41
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.12
|
| Rate for Payer: Priority Health Narrow Network |
$38.12
|
| Rate for Payer: Priority Health SBD |
$38.12
|
| Rate for Payer: UMR Bronson Commercial |
$45.08
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 99458
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$140.53 |
| Rate for Payer: Aetna Commercial |
$31.23
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS Trust/PPO |
$140.53
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.12
|
| Rate for Payer: Priority Health Narrow Network |
$38.12
|
| Rate for Payer: Priority Health SBD |
$38.12
|
| Rate for Payer: UMR Bronson Commercial |
$36.80
|
|
|
PR REMOT IMAGE SUBMIT BY PT
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS G2010
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$9.26
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS Trust/PPO |
$119.40
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.57
|
| Rate for Payer: Priority Health Narrow Network |
$11.57
|
| Rate for Payer: Priority Health SBD |
$11.57
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
|
|
PR REMOVAL ANAL SETON OTHER MARKER
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 46030
|
| Min. Negotiated Rate |
$94.40 |
| Max. Negotiated Rate |
$1,184.45 |
| Rate for Payer: Aetna Commercial |
$119.25
|
| Rate for Payer: BCBS Complete |
$94.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.45
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.29
|
| Rate for Payer: Priority Health Narrow Network |
$152.29
|
| Rate for Payer: Priority Health SBD |
$152.29
|
| Rate for Payer: UMR Bronson Commercial |
$108.56
|
|
|
PR REMOVAL ANKLE IMPLANT
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 27704
|
| Min. Negotiated Rate |
$366.79 |
| Max. Negotiated Rate |
$2,348.82 |
| Rate for Payer: Aetna Commercial |
$760.19
|
| Rate for Payer: BCBS Complete |
$385.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,348.82
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Meridian Medicaid |
$385.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,250.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.70
|
| Rate for Payer: Priority Health Narrow Network |
$872.70
|
| Rate for Payer: Priority Health SBD |
$872.70
|
| Rate for Payer: UMR Bronson Commercial |
$821.56
|
|
|
PR REMOVAL ANTERIOR INSTRUMENTATION
|
Professional
|
Both
|
$3,964.00
|
|
|
Service Code
|
HCPCS 22855
|
| Min. Negotiated Rate |
$210.26 |
| Max. Negotiated Rate |
$2,774.80 |
| Rate for Payer: Aetna Commercial |
$1,487.03
|
| Rate for Payer: BCBS Complete |
$751.92
|
| Rate for Payer: BCBS Trust/PPO |
$210.26
|
| Rate for Payer: Cash Price |
$3,171.20
|
| Rate for Payer: Cash Price |
$3,171.20
|
| Rate for Payer: Meridian Medicaid |
$751.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,774.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,703.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,703.53
|
| Rate for Payer: Priority Health SBD |
$1,703.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,823.44
|
|
|
PR REMOVAL/BIVALVING FULL ARM/FULL LEG CAST
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 29705
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$1,732.82 |
| Rate for Payer: Aetna Commercial |
$61.11
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.82
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.92
|
| Rate for Payer: Priority Health Narrow Network |
$67.92
|
| Rate for Payer: Priority Health SBD |
$67.92
|
| Rate for Payer: UMR Bronson Commercial |
$52.90
|
|
|
PR REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA
|
Professional
|
Both
|
$363.00
|
|
|
Service Code
|
HCPCS 59871
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$714.79 |
| Rate for Payer: Aetna Commercial |
$144.84
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS Trust/PPO |
$714.79
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.92
|
| Rate for Payer: Priority Health Narrow Network |
$187.92
|
| Rate for Payer: Priority Health SBD |
$187.92
|
| Rate for Payer: UMR Bronson Commercial |
$166.98
|
|
|
PR REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE
|
Professional
|
Both
|
$1,519.00
|
|
|
Service Code
|
HCPCS 21029
|
| Min. Negotiated Rate |
$401.93 |
| Max. Negotiated Rate |
$3,995.58 |
| Rate for Payer: Aetna Commercial |
$818.18
|
| Rate for Payer: BCBS Complete |
$422.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,995.58
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Meridian Medicaid |
$422.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$401.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$951.34
|
| Rate for Payer: Priority Health Narrow Network |
$951.34
|
| Rate for Payer: Priority Health SBD |
$951.34
|
| Rate for Payer: UMR Bronson Commercial |
$698.74
|
|
|
PR REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO
|
Professional
|
Both
|
$1,511.00
|
|
|
Service Code
|
HCPCS 64570
|
| Min. Negotiated Rate |
$427.92 |
| Max. Negotiated Rate |
$1,264.38 |
| Rate for Payer: Aetna Commercial |
$944.34
|
| Rate for Payer: BCBS Complete |
$505.45
|
| Rate for Payer: BCBS Trust/PPO |
$427.92
|
| Rate for Payer: Cash Price |
$1,208.80
|
| Rate for Payer: Cash Price |
$1,208.80
|
| Rate for Payer: Meridian Medicaid |
$505.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,057.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,264.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,264.38
|
| Rate for Payer: Priority Health SBD |
$1,264.38
|
| Rate for Payer: UMR Bronson Commercial |
$695.06
|
|
