|
PR ARTIFICIAL INSEMINATION INTRA-UTERINE
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 58322
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$307.47 |
| Rate for Payer: Aetna Commercial |
$77.02
|
| Rate for Payer: Aetna Medicare |
$57.48
|
| Rate for Payer: BCBS Complete |
$96.00
|
| Rate for Payer: BCBS MAPPO |
$57.48
|
| Rate for Payer: BCBS Trust/PPO |
$307.47
|
| Rate for Payer: BCN Commercial |
$134.38
|
| Rate for Payer: BCN Medicare Advantage |
$57.48
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$82.77
|
| Rate for Payer: Cofinity Commercial |
$77.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.48
|
| Rate for Payer: Healthscope Commercial |
$68.98
|
| Rate for Payer: Healthscope Whirlpool |
$68.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.35
|
| Rate for Payer: PACE SWMI |
$57.48
|
| Rate for Payer: PHP Medicare Advantage |
$57.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.43
|
| Rate for Payer: Priority Health Medicare |
$57.48
|
| Rate for Payer: Priority Health Narrow Network |
$81.43
|
| Rate for Payer: UHC Medicare Advantage |
$59.20
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 36625
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$664.07 |
| Rate for Payer: Aetna Commercial |
$139.80
|
| Rate for Payer: Aetna Medicare |
$104.33
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS MAPPO |
$104.33
|
| Rate for Payer: BCBS Trust/PPO |
$664.07
|
| Rate for Payer: BCN Commercial |
$151.98
|
| Rate for Payer: BCN Medicare Advantage |
$104.33
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$139.80
|
| Rate for Payer: Cofinity Commercial |
$150.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.33
|
| Rate for Payer: Healthscope Commercial |
$125.20
|
| Rate for Payer: Healthscope Whirlpool |
$125.20
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$109.55
|
| Rate for Payer: PACE SWMI |
$104.33
|
| Rate for Payer: PHP Medicare Advantage |
$104.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.44
|
| Rate for Payer: Priority Health Medicare |
$104.33
|
| Rate for Payer: Priority Health Narrow Network |
$165.44
|
| Rate for Payer: UHC Medicare Advantage |
$107.46
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 36620
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$962.03 |
| Rate for Payer: Aetna Commercial |
$58.99
|
| Rate for Payer: Aetna Medicare |
$44.02
|
| Rate for Payer: BCBS Complete |
$29.07
|
| Rate for Payer: BCBS MAPPO |
$44.02
|
| Rate for Payer: BCBS Trust/PPO |
$962.03
|
| Rate for Payer: BCN Commercial |
$64.02
|
| Rate for Payer: BCN Medicare Advantage |
$44.02
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$63.39
|
| Rate for Payer: Cofinity Commercial |
$58.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.02
|
| Rate for Payer: Healthscope Commercial |
$52.82
|
| Rate for Payer: Healthscope Whirlpool |
$52.82
|
| Rate for Payer: Meridian Medicaid |
$29.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.22
|
| Rate for Payer: PACE SWMI |
$44.02
|
| Rate for Payer: PHP Medicare Advantage |
$44.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.68
|
| Rate for Payer: Priority Health Medicare |
$44.02
|
| Rate for Payer: Priority Health Narrow Network |
$69.68
|
| Rate for Payer: UHC Medicare Advantage |
$45.34
|
|
|
PR ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
HCPCS 36640
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$802.49 |
| Rate for Payer: Aetna Commercial |
$152.06
|
| Rate for Payer: Aetna Medicare |
$113.48
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$113.48
|
| Rate for Payer: BCBS Trust/PPO |
$802.49
|
| Rate for Payer: BCN Commercial |
$168.11
|
| Rate for Payer: BCN Medicare Advantage |
$113.48
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cofinity Commercial |
$163.41
|
| Rate for Payer: Cofinity Commercial |
$152.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.48
|
| Rate for Payer: Healthscope Commercial |
$136.18
|
| Rate for Payer: Healthscope Whirlpool |
$136.18
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.15
|
| Rate for Payer: PACE SWMI |
$113.48
|
| Rate for Payer: PHP Medicare Advantage |
$113.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.99
|
| Rate for Payer: Priority Health Medicare |
$113.48
|
| Rate for Payer: Priority Health Narrow Network |
$182.99
|
| Rate for Payer: UHC Medicare Advantage |
$116.88
|
|
|
PR ARVEN ANAST OPN F/ARM VEIN TRPOS
|
Professional
|
Both
|
$1,494.00
|
|
|
Service Code
|
HCPCS 36820
|
| Min. Negotiated Rate |
$454.54 |
| Max. Negotiated Rate |
$1,126.68 |
| Rate for Payer: Aetna Commercial |
$952.28
|
| Rate for Payer: Aetna Medicare |
$710.66
|
| Rate for Payer: BCBS Complete |
$477.27
|
| Rate for Payer: BCBS MAPPO |
$710.66
|
| Rate for Payer: BCBS Trust/PPO |
$769.73
|
| Rate for Payer: BCN Commercial |
$1,035.02
|
| Rate for Payer: BCN Medicare Advantage |
$710.66
|
| Rate for Payer: Cash Price |
$1,195.20
|
| Rate for Payer: Cash Price |
$1,195.20
|
| Rate for Payer: Cofinity Commercial |
$952.28
|
| Rate for Payer: Cofinity Commercial |
$1,023.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$710.66
|
| Rate for Payer: Healthscope Commercial |
$852.79
|
| Rate for Payer: Healthscope Whirlpool |
$852.79
|
| Rate for Payer: Meridian Medicaid |
$477.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$746.19
|
| Rate for Payer: PACE SWMI |
$710.66
|
| Rate for Payer: PHP Medicare Advantage |
$710.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,126.68
|
| Rate for Payer: Priority Health Medicare |
$710.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,126.68
|
| Rate for Payer: UHC Medicare Advantage |
$731.98
|
|
|
PR ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS
|
Professional
|
Both
|
$2,387.00
|
|
|
Service Code
|
HCPCS 36819
|
| Min. Negotiated Rate |
$156.91 |
| Max. Negotiated Rate |
$1,670.90 |
| Rate for Payer: Aetna Commercial |
$961.85
|
| Rate for Payer: Aetna Medicare |
$717.80
|
| Rate for Payer: BCBS Complete |
$479.73
|
| Rate for Payer: BCBS MAPPO |
$717.80
|
| Rate for Payer: BCBS Trust/PPO |
$156.91
|
| Rate for Payer: BCN Commercial |
$1,044.31
|
| Rate for Payer: BCN Medicare Advantage |
$717.80
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cofinity Commercial |
$961.85
|
| Rate for Payer: Cofinity Commercial |
$1,033.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.80
|
| Rate for Payer: Healthscope Commercial |
$861.36
|
| Rate for Payer: Healthscope Whirlpool |
$861.36
|
| Rate for Payer: Meridian Medicaid |
$479.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$753.69
|
| Rate for Payer: PACE SWMI |
$717.80
|
| Rate for Payer: PHP Medicare Advantage |
$717.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,670.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,136.79
|
| Rate for Payer: Priority Health Medicare |
$717.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,136.79
|
| Rate for Payer: UHC Medicare Advantage |
$739.33
|
|
|
PR ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS
|
Professional
|
Both
|
$1,970.00
|
|
|
Service Code
|
HCPCS 36818
|
| Min. Negotiated Rate |
$431.54 |
| Max. Negotiated Rate |
$1,379.00 |
| Rate for Payer: Aetna Commercial |
$907.69
|
| Rate for Payer: Aetna Medicare |
$677.38
|
| Rate for Payer: BCBS Complete |
$453.12
|
| Rate for Payer: BCBS MAPPO |
$677.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.17
|
| Rate for Payer: BCN Commercial |
$986.64
|
| Rate for Payer: BCN Medicare Advantage |
$677.38
|
| Rate for Payer: Cash Price |
$1,576.00
|
| Rate for Payer: Cash Price |
$1,576.00
|
| Rate for Payer: Cofinity Commercial |
$975.43
|
| Rate for Payer: Cofinity Commercial |
$907.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$677.38
|
| Rate for Payer: Healthscope Commercial |
$812.86
|
| Rate for Payer: Healthscope Whirlpool |
$812.86
|
| Rate for Payer: Meridian Medicaid |
$453.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$711.25
|
| Rate for Payer: PACE SWMI |
$677.38
|
| Rate for Payer: PHP Medicare Advantage |
$677.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,074.02
|
| Rate for Payer: Priority Health Medicare |
$677.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,074.02
|
| Rate for Payer: UHC Medicare Advantage |
$697.70
|
|
|
PR ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART
|
Professional
|
Both
|
$8,262.00
|
|
|
Service Code
|
HCPCS 61705
|
| Min. Negotiated Rate |
$404.15 |
| Max. Negotiated Rate |
$5,783.40 |
| Rate for Payer: Aetna Commercial |
$3,513.55
|
| Rate for Payer: Aetna Medicare |
$2,622.05
|
| Rate for Payer: BCBS Complete |
$1,767.73
|
| Rate for Payer: BCBS MAPPO |
$2,622.05
|
| Rate for Payer: BCBS Trust/PPO |
$404.15
|
| Rate for Payer: BCN Commercial |
$3,832.21
|
| Rate for Payer: BCN Medicare Advantage |
$2,622.05
|
| Rate for Payer: Cash Price |
$6,609.60
|
| Rate for Payer: Cash Price |
$6,609.60
|
| Rate for Payer: Cofinity Commercial |
$3,775.75
|
| Rate for Payer: Cofinity Commercial |
$3,513.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,622.05
|
| Rate for Payer: Healthscope Commercial |
$3,146.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,146.46
|
| Rate for Payer: Meridian Medicaid |
$1,767.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,753.15
|
| Rate for Payer: PACE SWMI |
$2,622.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,622.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,683.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,783.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,440.32
|
| Rate for Payer: Priority Health Medicare |
$2,622.05
|
| Rate for Payer: Priority Health Narrow Network |
$4,440.32
|
| Rate for Payer: UHC Medicare Advantage |
$2,700.71
|
|
|
PR ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH
|
Professional
|
Both
|
$2,046.00
|
|
|
Service Code
|
HCPCS 31400
|
| Min. Negotiated Rate |
$649.44 |
| Max. Negotiated Rate |
$1,845.88 |
| Rate for Payer: Aetna Commercial |
$1,322.27
|
| Rate for Payer: Aetna Medicare |
$986.77
|
| Rate for Payer: BCBS Complete |
$681.91
|
| Rate for Payer: BCBS MAPPO |
$986.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,845.88
|
| Rate for Payer: BCN Commercial |
$1,491.93
|
| Rate for Payer: BCN Medicare Advantage |
$986.77
|
| Rate for Payer: Cash Price |
$1,636.80
|
| Rate for Payer: Cash Price |
$1,636.80
|
| Rate for Payer: Cofinity Commercial |
$1,420.95
|
| Rate for Payer: Cofinity Commercial |
$1,322.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$986.77
|
| Rate for Payer: Healthscope Commercial |
$1,184.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,184.12
|
| Rate for Payer: Meridian Medicaid |
$681.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,036.11
|
| Rate for Payer: PACE SWMI |
$986.77
|
| Rate for Payer: PHP Medicare Advantage |
$986.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$649.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,413.68
|
| Rate for Payer: Priority Health Medicare |
$986.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,413.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,016.37
|
|
|
PR AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT
|
Professional
|
Both
|
$6,492.28
|
|
|
Service Code
|
HCPCS 33863
|
| Min. Negotiated Rate |
$745.43 |
| Max. Negotiated Rate |
$4,892.42 |
| Rate for Payer: Aetna Commercial |
$4,144.66
|
| Rate for Payer: Aetna Medicare |
$3,093.03
|
| Rate for Payer: BCBS Complete |
$2,061.60
|
| Rate for Payer: BCBS MAPPO |
$3,093.03
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$4,494.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,093.03
|
| Rate for Payer: Cash Price |
$5,193.82
|
| Rate for Payer: Cash Price |
$5,193.82
|
| Rate for Payer: Cofinity Commercial |
$4,453.96
|
| Rate for Payer: Cofinity Commercial |
$4,144.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,093.03
|
| Rate for Payer: Healthscope Commercial |
$3,711.64
|
| Rate for Payer: Healthscope Whirlpool |
$3,711.64
|
| Rate for Payer: Meridian Medicaid |
$2,061.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,247.68
|
| Rate for Payer: PACE SWMI |
$3,093.03
|
| Rate for Payer: PHP Medicare Advantage |
$3,093.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,963.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,544.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,892.42
|
| Rate for Payer: Priority Health Medicare |
$3,093.03
|
| Rate for Payer: Priority Health Narrow Network |
$4,892.42
|
| Rate for Payer: UHC Medicare Advantage |
$3,185.82
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION
|
Professional
|
Both
|
$6,985.00
|
|
|
Service Code
|
HCPCS 33858
|
| Min. Negotiated Rate |
$313.81 |
| Max. Negotiated Rate |
$5,281.27 |
| Rate for Payer: Aetna Commercial |
$4,473.84
|
| Rate for Payer: Aetna Medicare |
$3,338.69
|
| Rate for Payer: BCBS Complete |
$2,224.20
|
| Rate for Payer: BCBS MAPPO |
$3,338.69
|
| Rate for Payer: BCBS Trust/PPO |
$313.81
|
| Rate for Payer: BCN Commercial |
$4,851.59
|
| Rate for Payer: BCN Medicare Advantage |
$3,338.69
|
| Rate for Payer: Cash Price |
$5,588.00
|
| Rate for Payer: Cash Price |
$5,588.00
|
| Rate for Payer: Cofinity Commercial |
$4,807.71
|
| Rate for Payer: Cofinity Commercial |
$4,473.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,338.69
|
| Rate for Payer: Healthscope Commercial |
$4,006.43
|
| Rate for Payer: Healthscope Whirlpool |
$4,006.43
|
| Rate for Payer: Meridian Medicaid |
$2,224.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,505.62
|
| Rate for Payer: PACE SWMI |
$3,338.69
|
| Rate for Payer: PHP Medicare Advantage |
$3,338.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,118.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,889.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,281.27
|
| Rate for Payer: Priority Health Medicare |
$3,338.69
|
| Rate for Payer: Priority Health Narrow Network |
$5,281.27
|
| Rate for Payer: UHC Medicare Advantage |
$3,438.85
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ
|
Professional
|
Both
|
$5,011.00
|
|
|
Service Code
|
HCPCS 33859
|
| Min. Negotiated Rate |
$1,128.45 |
| Max. Negotiated Rate |
$3,793.40 |
| Rate for Payer: Aetna Commercial |
$3,210.75
|
| Rate for Payer: Aetna Medicare |
$2,396.08
|
| Rate for Payer: BCBS Complete |
$1,598.88
|
| Rate for Payer: BCBS MAPPO |
$2,396.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.45
|
| Rate for Payer: BCN Commercial |
$3,484.76
|
| Rate for Payer: BCN Medicare Advantage |
$2,396.08
|
| Rate for Payer: Cash Price |
$4,008.80
|
| Rate for Payer: Cash Price |
$4,008.80
|
| Rate for Payer: Cofinity Commercial |
$3,450.36
|
| Rate for Payer: Cofinity Commercial |
$3,210.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,396.08
|
| Rate for Payer: Healthscope Commercial |
$2,875.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,875.30
|
| Rate for Payer: Meridian Medicaid |
$1,598.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,515.88
|
| Rate for Payer: PACE SWMI |
$2,396.08
|
| Rate for Payer: PHP Medicare Advantage |
$2,396.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,522.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,507.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,793.40
|
| Rate for Payer: Priority Health Medicare |
$2,396.08
|
| Rate for Payer: Priority Health Narrow Network |
$3,793.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,467.96
|
|
|
PR ASCEND AORTA GRAFT INCL VAVLE SUSPENSION
|
Professional
|
Both
|
$9,858.00
|
|
|
Service Code
|
HCPCS 33860
|
| Min. Negotiated Rate |
$3,943.20 |
| Max. Negotiated Rate |
$6,900.60 |
| Rate for Payer: BCBS Complete |
$3,943.20
|
| Rate for Payer: Cash Price |
$7,886.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,900.60
|
|
|
PR ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL
|
Professional
|
Both
|
$5,125.00
|
|
|
Service Code
|
HCPCS 33864
|
| Min. Negotiated Rate |
$1,166.49 |
| Max. Negotiated Rate |
$5,000.94 |
| Rate for Payer: Aetna Commercial |
$4,236.96
|
| Rate for Payer: Aetna Medicare |
$3,161.91
|
| Rate for Payer: BCBS Complete |
$2,105.44
|
| Rate for Payer: BCBS MAPPO |
$3,161.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,166.49
|
| Rate for Payer: BCN Commercial |
$4,594.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,161.91
|
| Rate for Payer: Cash Price |
$4,100.00
|
| Rate for Payer: Cash Price |
$4,100.00
|
| Rate for Payer: Cofinity Commercial |
$4,236.96
|
| Rate for Payer: Cofinity Commercial |
$4,553.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,161.91
|
| Rate for Payer: Healthscope Commercial |
$3,794.29
|
| Rate for Payer: Healthscope Whirlpool |
$3,794.29
|
| Rate for Payer: Meridian Medicaid |
$2,105.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,320.01
|
| Rate for Payer: PACE SWMI |
$3,161.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,161.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,005.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,587.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,000.94
|
| Rate for Payer: Priority Health Medicare |
$3,161.91
|
| Rate for Payer: Priority Health Narrow Network |
$5,000.94
|
| Rate for Payer: UHC Medicare Advantage |
$3,256.77
|
|
|
PR ASPIRATION AND/OR INJECTION THYROID CYST
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS 60300
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$3,338.86 |
| Rate for Payer: Aetna Commercial |
$63.82
|
| Rate for Payer: Aetna Medicare |
$47.63
|
| Rate for Payer: BCBS Complete |
$31.98
|
| Rate for Payer: BCBS MAPPO |
$47.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,338.86
|
| Rate for Payer: BCN Commercial |
$157.35
|
| Rate for Payer: BCN Medicare Advantage |
$47.63
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cofinity Commercial |
$63.82
|
| Rate for Payer: Cofinity Commercial |
$68.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.63
|
| Rate for Payer: Healthscope Commercial |
$57.16
|
| Rate for Payer: Healthscope Whirlpool |
$57.16
|
| Rate for Payer: Meridian Medicaid |
$31.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.01
|
| Rate for Payer: PACE SWMI |
$47.63
|
| Rate for Payer: PHP Medicare Advantage |
$47.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.66
|
| Rate for Payer: Priority Health Medicare |
$47.63
|
| Rate for Payer: Priority Health Narrow Network |
$67.66
|
| Rate for Payer: UHC Medicare Advantage |
$49.06
|
|
|
PR ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 51102
|
| Min. Negotiated Rate |
$89.89 |
| Max. Negotiated Rate |
$1,872.30 |
| Rate for Payer: Aetna Commercial |
$187.73
|
| Rate for Payer: Aetna Medicare |
$140.10
|
| Rate for Payer: BCBS Complete |
$94.38
|
| Rate for Payer: BCBS MAPPO |
$140.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,872.30
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$140.10
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$201.74
|
| Rate for Payer: Cofinity Commercial |
$187.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.10
|
| Rate for Payer: Healthscope Commercial |
$168.12
|
| Rate for Payer: Healthscope Whirlpool |
$168.12
|
| Rate for Payer: Meridian Medicaid |
$94.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.10
|
| Rate for Payer: PACE SWMI |
$140.10
|
| Rate for Payer: PHP Medicare Advantage |
$140.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.02
|
| Rate for Payer: Priority Health Medicare |
$140.10
|
| Rate for Payer: Priority Health Narrow Network |
$228.02
|
| Rate for Payer: UHC Medicare Advantage |
$144.30
|
|
|
PR ASPIRATION BLADDER NEEDLE
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 51100
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$2,925.20 |
| Rate for Payer: Aetna Commercial |
$51.47
|
| Rate for Payer: Aetna Medicare |
$38.41
|
| Rate for Payer: BCBS Complete |
$25.95
|
| Rate for Payer: BCBS MAPPO |
$38.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,925.20
|
| Rate for Payer: BCN Commercial |
$107.02
|
| Rate for Payer: BCN Medicare Advantage |
$38.41
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$55.31
|
| Rate for Payer: Cofinity Commercial |
$51.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.41
|
| Rate for Payer: Healthscope Commercial |
$46.09
|
| Rate for Payer: Healthscope Whirlpool |
$46.09
|
| Rate for Payer: Meridian Medicaid |
$25.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.33
|
| Rate for Payer: PACE SWMI |
$38.41
|
| Rate for Payer: PHP Medicare Advantage |
$38.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$38.41
|
| Rate for Payer: Priority Health Narrow Network |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$39.56
|
|
|
PR ASPIRATION BLADDER TROCAR/INTRACATHETER
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 51101
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$2,914.10 |
| Rate for Payer: Aetna Commercial |
$66.66
|
| Rate for Payer: Aetna Medicare |
$49.75
|
| Rate for Payer: BCBS Complete |
$33.77
|
| Rate for Payer: BCBS MAPPO |
$49.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,914.10
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$49.75
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cofinity Commercial |
$71.64
|
| Rate for Payer: Cofinity Commercial |
$66.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.75
|
| Rate for Payer: Healthscope Commercial |
$59.70
|
| Rate for Payer: Healthscope Whirlpool |
$59.70
|
| Rate for Payer: Meridian Medicaid |
$33.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.24
|
| Rate for Payer: PACE SWMI |
$49.75
|
| Rate for Payer: PHP Medicare Advantage |
$49.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.51
|
| Rate for Payer: Priority Health Medicare |
$49.75
|
| Rate for Payer: Priority Health Narrow Network |
$80.51
|
| Rate for Payer: UHC Medicare Advantage |
$51.24
|
|
|
PR ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 20612
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$2,114.22 |
| Rate for Payer: Aetna Commercial |
$54.04
|
| Rate for Payer: Aetna Medicare |
$40.33
|
| Rate for Payer: BCBS Complete |
$27.51
|
| Rate for Payer: BCBS MAPPO |
$40.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,114.22
|
| Rate for Payer: BCN Commercial |
$93.82
|
| Rate for Payer: BCN Medicare Advantage |
$40.33
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$58.08
|
| Rate for Payer: Cofinity Commercial |
$54.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.33
|
| Rate for Payer: Healthscope Commercial |
$48.40
|
| Rate for Payer: Healthscope Whirlpool |
$48.40
|
| Rate for Payer: Meridian Medicaid |
$27.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.35
|
| Rate for Payer: PACE SWMI |
$40.33
|
| Rate for Payer: PHP Medicare Advantage |
$40.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.30
|
| Rate for Payer: Priority Health Medicare |
$40.33
|
| Rate for Payer: Priority Health Narrow Network |
$62.30
|
| Rate for Payer: UHC Medicare Advantage |
$41.54
|
|
|
PR ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR
|
Professional
|
Both
|
$199.00
|
|
|
Service Code
|
HCPCS 96105
|
| Min. Negotiated Rate |
$79.60 |
| Max. Negotiated Rate |
$332.30 |
| Rate for Payer: Aetna Commercial |
$127.78
|
| Rate for Payer: Aetna Medicare |
$95.36
|
| Rate for Payer: BCBS Complete |
$79.60
|
| Rate for Payer: BCBS MAPPO |
$95.36
|
| Rate for Payer: BCBS Trust/PPO |
$332.30
|
| Rate for Payer: BCN Commercial |
$141.72
|
| Rate for Payer: BCN Medicare Advantage |
$95.36
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cofinity Commercial |
$127.78
|
| Rate for Payer: Cofinity Commercial |
$137.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.36
|
| Rate for Payer: Healthscope Commercial |
$114.43
|
| Rate for Payer: Healthscope Whirlpool |
$114.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.13
|
| Rate for Payer: PACE SWMI |
$95.36
|
| Rate for Payer: PHP Medicare Advantage |
$95.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.25
|
| Rate for Payer: Priority Health Medicare |
$95.36
|
| Rate for Payer: Priority Health Narrow Network |
$130.25
|
| Rate for Payer: UHC Medicare Advantage |
$98.22
|
|
|
PR ASSESSMENT FOR HEARING AID
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS V5010
|
| Min. Negotiated Rate |
$47.05 |
| Max. Negotiated Rate |
$98.00 |
| Rate for Payer: Aetna Commercial |
$47.05
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
|
|
PR ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 99483
|
| Min. Negotiated Rate |
$122.26 |
| Max. Negotiated Rate |
$405.21 |
| Rate for Payer: Aetna Commercial |
$254.51
|
| Rate for Payer: Aetna Medicare |
$189.93
|
| Rate for Payer: BCBS Complete |
$128.37
|
| Rate for Payer: BCBS MAPPO |
$189.93
|
| Rate for Payer: BCBS Trust/PPO |
$405.21
|
| Rate for Payer: BCN Commercial |
$288.40
|
| Rate for Payer: BCN Medicare Advantage |
$189.93
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$273.50
|
| Rate for Payer: Cofinity Commercial |
$254.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.93
|
| Rate for Payer: Healthscope Commercial |
$208.92
|
| Rate for Payer: Healthscope Whirlpool |
$208.92
|
| Rate for Payer: Meridian Medicaid |
$128.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.43
|
| Rate for Payer: PACE SWMI |
$189.93
|
| Rate for Payer: PHP Medicare Advantage |
$189.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.42
|
| Rate for Payer: Priority Health Medicare |
$189.93
|
| Rate for Payer: Priority Health Narrow Network |
$245.42
|
| Rate for Payer: UHC Medicare Advantage |
$195.63
|
|
|
PR ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE
|
Professional
|
Both
|
$1,495.00
|
|
|
Service Code
|
HCPCS 33257
|
| Min. Negotiated Rate |
$367.43 |
| Max. Negotiated Rate |
$2,631.46 |
| Rate for Payer: Aetna Commercial |
$765.72
|
| Rate for Payer: Aetna Medicare |
$571.43
|
| Rate for Payer: BCBS Complete |
$385.80
|
| Rate for Payer: BCBS MAPPO |
$571.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,631.46
|
| Rate for Payer: BCN Commercial |
$838.57
|
| Rate for Payer: BCN Medicare Advantage |
$571.43
|
| Rate for Payer: Cash Price |
$1,196.00
|
| Rate for Payer: Cash Price |
$1,196.00
|
| Rate for Payer: Cofinity Commercial |
$765.72
|
| Rate for Payer: Cofinity Commercial |
$822.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.43
|
| Rate for Payer: Healthscope Commercial |
$685.72
|
| Rate for Payer: Healthscope Whirlpool |
$685.72
|
| Rate for Payer: Meridian Medicaid |
$385.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$600.00
|
| Rate for Payer: PACE SWMI |
$571.43
|
| Rate for Payer: PHP Medicare Advantage |
$571.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,046.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$912.83
|
| Rate for Payer: Priority Health Medicare |
$571.43
|
| Rate for Payer: Priority Health Narrow Network |
$912.83
|
| Rate for Payer: UHC Medicare Advantage |
$588.57
|
|
|
PR ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS
|
Professional
|
Both
|
$2,258.00
|
|
|
Service Code
|
HCPCS 33259
|
| Min. Negotiated Rate |
$533.78 |
| Max. Negotiated Rate |
$5,209.57 |
| Rate for Payer: Aetna Commercial |
$1,111.13
|
| Rate for Payer: Aetna Medicare |
$829.20
|
| Rate for Payer: BCBS Complete |
$560.47
|
| Rate for Payer: BCBS MAPPO |
$829.20
|
| Rate for Payer: BCBS Trust/PPO |
$5,209.57
|
| Rate for Payer: BCN Commercial |
$1,216.32
|
| Rate for Payer: BCN Medicare Advantage |
$829.20
|
| Rate for Payer: Cash Price |
$1,806.40
|
| Rate for Payer: Cash Price |
$1,806.40
|
| Rate for Payer: Cofinity Commercial |
$1,194.05
|
| Rate for Payer: Cofinity Commercial |
$1,111.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.20
|
| Rate for Payer: Healthscope Commercial |
$995.04
|
| Rate for Payer: Healthscope Whirlpool |
$995.04
|
| Rate for Payer: Meridian Medicaid |
$560.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$870.66
|
| Rate for Payer: PACE SWMI |
$829.20
|
| Rate for Payer: PHP Medicare Advantage |
$829.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$533.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,580.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,324.04
|
| Rate for Payer: Priority Health Medicare |
$829.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,324.04
|
| Rate for Payer: UHC Medicare Advantage |
$854.08
|
|
|
PR ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 99464
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$1,378.86 |
| Rate for Payer: Aetna Commercial |
$95.76
|
| Rate for Payer: Aetna Medicare |
$71.46
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$71.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,378.86
|
| Rate for Payer: BCN Commercial |
$105.06
|
| Rate for Payer: BCN Medicare Advantage |
$71.46
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$95.76
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.46
|
| Rate for Payer: Healthscope Commercial |
$78.61
|
| Rate for Payer: Healthscope Whirlpool |
$78.61
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.03
|
| Rate for Payer: PACE SWMI |
$71.46
|
| Rate for Payer: PHP Medicare Advantage |
$71.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$281.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.09
|
| Rate for Payer: Priority Health Medicare |
$71.46
|
| Rate for Payer: Priority Health Narrow Network |
$92.09
|
| Rate for Payer: UHC Medicare Advantage |
$73.60
|
|
