|
PR 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 99222
|
| Min. Negotiated Rate |
$82.64 |
| Max. Negotiated Rate |
$2,113.20 |
| Rate for Payer: Aetna Commercial |
$171.43
|
| Rate for Payer: Aetna Medicare |
$127.93
|
| Rate for Payer: BCBS Complete |
$86.77
|
| Rate for Payer: BCBS MAPPO |
$127.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,113.20
|
| Rate for Payer: BCN Commercial |
$137.93
|
| Rate for Payer: BCN Medicare Advantage |
$127.93
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$184.22
|
| Rate for Payer: Cofinity Commercial |
$171.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.93
|
| Rate for Payer: Healthscope Commercial |
$140.72
|
| Rate for Payer: Healthscope Whirlpool |
$140.72
|
| Rate for Payer: Meridian Medicaid |
$86.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.33
|
| Rate for Payer: PACE SWMI |
$127.93
|
| Rate for Payer: PHP Medicare Advantage |
$127.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.91
|
| Rate for Payer: Priority Health Medicare |
$127.93
|
| Rate for Payer: Priority Health Narrow Network |
$164.91
|
| Rate for Payer: UHC Medicare Advantage |
$131.77
|
|
|
PR 1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 99221
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$1,817.88 |
| Rate for Payer: Aetna Commercial |
$109.71
|
| Rate for Payer: Aetna Medicare |
$81.87
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS MAPPO |
$81.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,817.88
|
| Rate for Payer: BCN Commercial |
$88.13
|
| Rate for Payer: BCN Medicare Advantage |
$81.87
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$109.71
|
| Rate for Payer: Cofinity Commercial |
$117.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.87
|
| Rate for Payer: Healthscope Commercial |
$90.06
|
| Rate for Payer: Healthscope Whirlpool |
$90.06
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.96
|
| Rate for Payer: PACE SWMI |
$81.87
|
| Rate for Payer: PHP Medicare Advantage |
$81.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.36
|
| Rate for Payer: Priority Health Medicare |
$81.87
|
| Rate for Payer: Priority Health Narrow Network |
$105.36
|
| Rate for Payer: UHC Medicare Advantage |
$84.33
|
|
|
PR 1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<
|
Professional
|
Both
|
$1,642.00
|
|
|
Service Code
|
HCPCS 99468
|
| Min. Negotiated Rate |
$127.77 |
| Max. Negotiated Rate |
$1,290.60 |
| Rate for Payer: Aetna Commercial |
$1,176.41
|
| Rate for Payer: Aetna Medicare |
$877.92
|
| Rate for Payer: BCBS Complete |
$881.36
|
| Rate for Payer: BCBS MAPPO |
$877.92
|
| Rate for Payer: BCBS Trust/PPO |
$127.77
|
| Rate for Payer: BCN Commercial |
$1,290.60
|
| Rate for Payer: BCN Medicare Advantage |
$877.92
|
| Rate for Payer: Cash Price |
$1,313.60
|
| Rate for Payer: Cash Price |
$1,313.60
|
| Rate for Payer: Cofinity Commercial |
$1,264.20
|
| Rate for Payer: Cofinity Commercial |
$1,176.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$877.92
|
| Rate for Payer: Healthscope Commercial |
$965.71
|
| Rate for Payer: Healthscope Whirlpool |
$965.71
|
| Rate for Payer: Meridian Medicaid |
$881.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$921.82
|
| Rate for Payer: PACE SWMI |
$877.92
|
| Rate for Payer: PHP Medicare Advantage |
$877.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,149.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,131.19
|
| Rate for Payer: Priority Health Medicare |
$877.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,131.19
|
| Rate for Payer: UHC Medicare Advantage |
$904.26
|
|
|
PR 1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 99492
|
| Min. Negotiated Rate |
$59.43 |
| Max. Negotiated Rate |
$1,323.39 |
| Rate for Payer: Aetna Commercial |
$121.85
|
| Rate for Payer: Aetna Medicare |
$90.93
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS MAPPO |
$90.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,323.39
|
| Rate for Payer: BCN Commercial |
$193.46
|
| Rate for Payer: BCN Medicare Advantage |
$90.93
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$130.94
|
| Rate for Payer: Cofinity Commercial |
$121.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.93
|
| Rate for Payer: Healthscope Commercial |
$100.02
|
| Rate for Payer: Healthscope Whirlpool |
$100.02
|
| Rate for Payer: Meridian Medicaid |
$62.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.48
|
| Rate for Payer: PACE SWMI |
$90.93
|
| Rate for Payer: PHP Medicare Advantage |
$90.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.40
|
| Rate for Payer: Priority Health Medicare |
$90.93
|
| Rate for Payer: Priority Health Narrow Network |
$172.40
|
| Rate for Payer: UHC Medicare Advantage |
$93.66
|
|
|
PR 1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 99494
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$984.75 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$39.85
|
| Rate for Payer: BCBS Complete |
$27.29
|
| Rate for Payer: BCBS MAPPO |
$39.85
|
| Rate for Payer: BCBS Trust/PPO |
$984.75
|
| Rate for Payer: BCN Commercial |
$79.98
|
| Rate for Payer: BCN Medicare Advantage |
$39.85
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$57.38
|
| Rate for Payer: Cofinity Commercial |
$53.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.85
|
| Rate for Payer: Healthscope Commercial |
$43.84
|
| Rate for Payer: Healthscope Whirlpool |
$43.84
|
| Rate for Payer: Meridian Medicaid |
$27.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.84
|
| Rate for Payer: PACE SWMI |
$39.85
|
| Rate for Payer: PHP Medicare Advantage |
$39.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.71
|
| Rate for Payer: Priority Health Medicare |
$39.85
|
| Rate for Payer: Priority Health Narrow Network |
$82.71
|
| Rate for Payer: UHC Medicare Advantage |
$41.05
|
|
|
PR 2VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 90650
|
| Min. Negotiated Rate |
$109.60 |
| Max. Negotiated Rate |
$191.80 |
| Rate for Payer: Aetna Commercial |
$141.25
|
| Rate for Payer: BCBS Complete |
$109.60
|
| Rate for Payer: BCBS Trust/PPO |
$133.16
|
| Rate for Payer: BCN Commercial |
$133.16
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.80
|
|
|
PR 4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 90649
|
| Min. Negotiated Rate |
$103.20 |
| Max. Negotiated Rate |
$180.60 |
| Rate for Payer: Aetna Commercial |
$163.24
|
| Rate for Payer: BCBS Complete |
$103.20
|
| Rate for Payer: BCBS Trust/PPO |
$160.17
|
| Rate for Payer: BCN Commercial |
$160.17
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.60
|
|
|
PR 5% DEXTROSE IN LAC RINGERS
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS J7121
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna Commercial |
$7.42
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$1.86
|
| Rate for Payer: BCN Commercial |
$1.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
|
|
PR 9VHPV VACC 2/3 DOSE SCHED IM USE
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 90651
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$293.16 |
| Rate for Payer: Aetna Commercial |
$293.16
|
| Rate for Payer: BCBS Complete |
$116.00
|
| Rate for Payer: BCBS Trust/PPO |
$277.00
|
| Rate for Payer: BCN Commercial |
$265.15
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.00
|
|
|
PR AAA REPAIR,AORTO-AORTIC TUBE PROSTH
|
Professional
|
Both
|
$3,860.00
|
|
|
Service Code
|
HCPCS 34800
|
| Min. Negotiated Rate |
$1,544.00 |
| Max. Negotiated Rate |
$2,702.00 |
| Rate for Payer: BCBS Complete |
$1,544.00
|
| Rate for Payer: Cash Price |
$3,088.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,702.00
|
|
|
PR AAA REPAIR,MODULR BIFURCATED PROSTH
|
Professional
|
Both
|
$2,505.00
|
|
|
Service Code
|
HCPCS 34802
|
| Min. Negotiated Rate |
$1,002.00 |
| Max. Negotiated Rate |
$1,753.50 |
| Rate for Payer: BCBS Complete |
$1,002.00
|
| Rate for Payer: Cash Price |
$2,004.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,753.50
|
|
|
PR AAA REPAIR,MODULR BIFUR PROSTH,2-DOCK
|
Professional
|
Both
|
$2,571.00
|
|
|
Service Code
|
HCPCS 34803
|
| Min. Negotiated Rate |
$1,028.40 |
| Max. Negotiated Rate |
$1,799.70 |
| Rate for Payer: BCBS Complete |
$1,028.40
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.70
|
|
|
PR AAA REPAIR,UNIBODY BIFURCATED PROSTH
|
Professional
|
Both
|
$5,404.00
|
|
|
Service Code
|
HCPCS 34804
|
| Min. Negotiated Rate |
$2,161.60 |
| Max. Negotiated Rate |
$3,782.80 |
| Rate for Payer: BCBS Complete |
$2,161.60
|
| Rate for Payer: Cash Price |
$4,323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,782.80
|
|
|
PR AAA REPR,1ST VESSEL,EXTENSION PROSTH
|
Professional
|
Both
|
$2,645.00
|
|
|
Service Code
|
HCPCS 34825
|
| Min. Negotiated Rate |
$1,058.00 |
| Max. Negotiated Rate |
$1,851.50 |
| Rate for Payer: BCBS Complete |
$1,058.00
|
| Rate for Payer: Cash Price |
$2,116.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,851.50
|
|
|
PR AAA REPR,ADD VESSEL,EXTENSION PROSTH
|
Professional
|
Both
|
$427.00
|
|
|
Service Code
|
HCPCS 34826
|
| Min. Negotiated Rate |
$170.80 |
| Max. Negotiated Rate |
$298.90 |
| Rate for Payer: BCBS Complete |
$170.80
|
| Rate for Payer: Cash Price |
$341.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.90
|
|
|
PR ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 38747
|
| Min. Negotiated Rate |
$168.70 |
| Max. Negotiated Rate |
$784.00 |
| Rate for Payer: Aetna Commercial |
$353.83
|
| Rate for Payer: Aetna Medicare |
$264.05
|
| Rate for Payer: BCBS Complete |
$177.14
|
| Rate for Payer: BCBS MAPPO |
$264.05
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$384.59
|
| Rate for Payer: BCN Medicare Advantage |
$264.05
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cofinity Commercial |
$380.23
|
| Rate for Payer: Cofinity Commercial |
$353.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$264.05
|
| Rate for Payer: Healthscope Commercial |
$316.86
|
| Rate for Payer: Healthscope Whirlpool |
$316.86
|
| Rate for Payer: Meridian Medicaid |
$177.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$277.25
|
| Rate for Payer: PACE SWMI |
$264.05
|
| Rate for Payer: PHP Medicare Advantage |
$264.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.05
|
| Rate for Payer: Priority Health Medicare |
$264.05
|
| Rate for Payer: Priority Health Narrow Network |
$570.05
|
| Rate for Payer: UHC Medicare Advantage |
$271.97
|
|
|
PR ABDOMINOPLASTY (2HRS)
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 00364
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,040.00 |
| Max. Negotiated Rate |
$1,820.00 |
| Rate for Payer: BCBS Complete |
$1,040.00
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.00
|
|
|
PR ABDOMINOPLASTY (3HRS)
|
Professional
|
Both
|
$4,200.00
|
|
|
Service Code
|
HCPCS 00365
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,680.00 |
| Max. Negotiated Rate |
$2,940.00 |
| Rate for Payer: BCBS Complete |
$1,680.00
|
| Rate for Payer: Cash Price |
$3,360.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,940.00
|
|
|
PR ABDOMINOPLASTY W/ BREAST AUGMENT
|
Professional
|
Both
|
$7,300.00
|
|
|
Service Code
|
HCPCS 00256
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,920.00 |
| Max. Negotiated Rate |
$5,110.00 |
| Rate for Payer: BCBS Complete |
$2,920.00
|
| Rate for Payer: Cash Price |
$5,840.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,110.00
|
|
|
PR ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL
|
Professional
|
Both
|
$2,576.00
|
|
|
Service Code
|
HCPCS 51845
|
| Min. Negotiated Rate |
$371.69 |
| Max. Negotiated Rate |
$3,525.87 |
| Rate for Payer: Aetna Commercial |
$762.35
|
| Rate for Payer: Aetna Medicare |
$568.92
|
| Rate for Payer: BCBS Complete |
$390.27
|
| Rate for Payer: BCBS MAPPO |
$568.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,525.87
|
| Rate for Payer: BCN Commercial |
$841.50
|
| Rate for Payer: BCN Medicare Advantage |
$568.92
|
| Rate for Payer: Cash Price |
$2,060.80
|
| Rate for Payer: Cash Price |
$2,060.80
|
| Rate for Payer: Cofinity Commercial |
$819.24
|
| Rate for Payer: Cofinity Commercial |
$762.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$568.92
|
| Rate for Payer: Healthscope Commercial |
$682.70
|
| Rate for Payer: Healthscope Whirlpool |
$682.70
|
| Rate for Payer: Meridian Medicaid |
$390.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$597.37
|
| Rate for Payer: PACE SWMI |
$568.92
|
| Rate for Payer: PHP Medicare Advantage |
$568.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$930.50
|
| Rate for Payer: Priority Health Medicare |
$568.92
|
| Rate for Payer: Priority Health Narrow Network |
$930.50
|
| Rate for Payer: UHC Medicare Advantage |
$585.99
|
|
|
PR ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 49083
|
| Min. Negotiated Rate |
$66.46 |
| Max. Negotiated Rate |
$759.70 |
| Rate for Payer: Aetna Commercial |
$138.57
|
| Rate for Payer: Aetna Medicare |
$103.41
|
| Rate for Payer: BCBS Complete |
$69.78
|
| Rate for Payer: BCBS MAPPO |
$103.41
|
| Rate for Payer: BCBS Trust/PPO |
$759.70
|
| Rate for Payer: BCN Commercial |
$432.48
|
| Rate for Payer: BCN Medicare Advantage |
$103.41
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cofinity Commercial |
$138.57
|
| Rate for Payer: Cofinity Commercial |
$148.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.41
|
| Rate for Payer: Healthscope Commercial |
$124.09
|
| Rate for Payer: Healthscope Whirlpool |
$124.09
|
| Rate for Payer: Meridian Medicaid |
$69.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.58
|
| Rate for Payer: PACE SWMI |
$103.41
|
| Rate for Payer: PHP Medicare Advantage |
$103.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.45
|
| Rate for Payer: Priority Health Medicare |
$103.41
|
| Rate for Payer: Priority Health Narrow Network |
$183.45
|
| Rate for Payer: UHC Medicare Advantage |
$106.51
|
|
|
PR ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 49082
|
| Min. Negotiated Rate |
$46.43 |
| Max. Negotiated Rate |
$721.66 |
| Rate for Payer: Aetna Commercial |
$95.78
|
| Rate for Payer: Aetna Medicare |
$71.48
|
| Rate for Payer: BCBS Complete |
$48.75
|
| Rate for Payer: BCBS MAPPO |
$71.48
|
| Rate for Payer: BCBS Trust/PPO |
$721.66
|
| Rate for Payer: BCN Commercial |
$311.78
|
| Rate for Payer: BCN Medicare Advantage |
$71.48
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$95.78
|
| Rate for Payer: Cofinity Commercial |
$102.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.48
|
| Rate for Payer: Healthscope Commercial |
$85.78
|
| Rate for Payer: Healthscope Whirlpool |
$85.78
|
| Rate for Payer: Meridian Medicaid |
$48.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.05
|
| Rate for Payer: PACE SWMI |
$71.48
|
| Rate for Payer: PHP Medicare Advantage |
$71.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.01
|
| Rate for Payer: Priority Health Medicare |
$71.48
|
| Rate for Payer: Priority Health Narrow Network |
$127.01
|
| Rate for Payer: UHC Medicare Advantage |
$73.62
|
|
|
PR ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN
|
Professional
|
Both
|
$859.00
|
|
|
Service Code
|
HCPCS 93657
|
| Min. Negotiated Rate |
$190.85 |
| Max. Negotiated Rate |
$3,654.78 |
| Rate for Payer: Aetna Commercial |
$406.09
|
| Rate for Payer: Aetna Medicare |
$303.05
|
| Rate for Payer: BCBS Complete |
$200.39
|
| Rate for Payer: BCBS MAPPO |
$303.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,654.78
|
| Rate for Payer: BCN Commercial |
$442.74
|
| Rate for Payer: BCN Medicare Advantage |
$303.05
|
| Rate for Payer: Cash Price |
$687.20
|
| Rate for Payer: Cash Price |
$687.20
|
| Rate for Payer: Cofinity Commercial |
$436.39
|
| Rate for Payer: Cofinity Commercial |
$406.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.05
|
| Rate for Payer: Healthscope Commercial |
$363.66
|
| Rate for Payer: Healthscope Whirlpool |
$363.66
|
| Rate for Payer: Meridian Medicaid |
$200.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.20
|
| Rate for Payer: PACE SWMI |
$303.05
|
| Rate for Payer: PHP Medicare Advantage |
$303.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.42
|
| Rate for Payer: Priority Health Medicare |
$303.05
|
| Rate for Payer: Priority Health Narrow Network |
$428.42
|
| Rate for Payer: UHC Medicare Advantage |
$312.14
|
|
|
PR ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS
|
Professional
|
Both
|
$3,692.00
|
|
|
Service Code
|
HCPCS 33256
|
| Min. Negotiated Rate |
$1,203.66 |
| Max. Negotiated Rate |
$3,001.31 |
| Rate for Payer: Aetna Commercial |
$2,533.81
|
| Rate for Payer: Aetna Medicare |
$1,890.90
|
| Rate for Payer: BCBS Complete |
$1,263.84
|
| Rate for Payer: BCBS MAPPO |
$1,890.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,285.88
|
| Rate for Payer: BCN Commercial |
$2,757.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,890.90
|
| Rate for Payer: Cash Price |
$2,953.60
|
| Rate for Payer: Cash Price |
$2,953.60
|
| Rate for Payer: Cofinity Commercial |
$2,533.81
|
| Rate for Payer: Cofinity Commercial |
$2,722.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,890.90
|
| Rate for Payer: Healthscope Commercial |
$2,269.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,269.08
|
| Rate for Payer: Meridian Medicaid |
$1,263.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,985.44
|
| Rate for Payer: PACE SWMI |
$1,890.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,890.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,203.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,584.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,001.31
|
| Rate for Payer: Priority Health Medicare |
$1,890.90
|
| Rate for Payer: Priority Health Narrow Network |
$3,001.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,947.63
|
|
|
PR ABLATION & RECONSTRUCTION ATRIA LIMITED
|
Professional
|
Both
|
$3,293.00
|
|
|
Service Code
|
HCPCS 33254
|
| Min. Negotiated Rate |
$856.47 |
| Max. Negotiated Rate |
$2,305.10 |
| Rate for Payer: Aetna Commercial |
$1,788.87
|
| Rate for Payer: Aetna Medicare |
$1,334.98
|
| Rate for Payer: BCBS Complete |
$899.29
|
| Rate for Payer: BCBS MAPPO |
$1,334.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,663.62
|
| Rate for Payer: BCN Commercial |
$1,950.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,334.98
|
| Rate for Payer: Cash Price |
$2,634.40
|
| Rate for Payer: Cash Price |
$2,634.40
|
| Rate for Payer: Cofinity Commercial |
$1,922.37
|
| Rate for Payer: Cofinity Commercial |
$1,788.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,334.98
|
| Rate for Payer: Healthscope Commercial |
$1,601.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,601.98
|
| Rate for Payer: Meridian Medicaid |
$899.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,401.73
|
| Rate for Payer: PACE SWMI |
$1,334.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,334.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$856.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,305.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,123.58
|
| Rate for Payer: Priority Health Medicare |
$1,334.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,123.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,375.03
|
|
