|
PR BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$2,495.00
|
|
|
Service Code
|
HCPCS 62269
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$1,746.50 |
| Rate for Payer: Aetna Commercial |
$341.66
|
| Rate for Payer: Aetna Medicare |
$254.97
|
| Rate for Payer: BCBS Complete |
$171.10
|
| Rate for Payer: BCBS MAPPO |
$254.97
|
| Rate for Payer: BCBS Trust/PPO |
$567.92
|
| Rate for Payer: BCN Commercial |
$375.79
|
| Rate for Payer: BCN Medicare Advantage |
$254.97
|
| Rate for Payer: Cash Price |
$1,996.00
|
| Rate for Payer: Cash Price |
$1,996.00
|
| Rate for Payer: Cofinity Commercial |
$367.16
|
| Rate for Payer: Cofinity Commercial |
$341.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.97
|
| Rate for Payer: Healthscope Commercial |
$305.96
|
| Rate for Payer: Healthscope Whirlpool |
$305.96
|
| Rate for Payer: Meridian Medicaid |
$171.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$267.72
|
| Rate for Payer: PACE SWMI |
$254.97
|
| Rate for Payer: PHP Medicare Advantage |
$254.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.42
|
| Rate for Payer: Priority Health Medicare |
$254.97
|
| Rate for Payer: Priority Health Narrow Network |
$435.42
|
| Rate for Payer: UHC Medicare Advantage |
$262.62
|
|
|
PR BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$668.00
|
|
|
Service Code
|
HCPCS 54505
|
| Min. Negotiated Rate |
$133.76 |
| Max. Negotiated Rate |
$1,963.16 |
| Rate for Payer: Aetna Commercial |
$274.18
|
| Rate for Payer: Aetna Medicare |
$204.61
|
| Rate for Payer: BCBS Complete |
$140.45
|
| Rate for Payer: BCBS MAPPO |
$204.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,963.16
|
| Rate for Payer: BCN Commercial |
$303.46
|
| Rate for Payer: BCN Medicare Advantage |
$204.61
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Cofinity Commercial |
$294.64
|
| Rate for Payer: Cofinity Commercial |
$274.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.61
|
| Rate for Payer: Healthscope Commercial |
$245.53
|
| Rate for Payer: Healthscope Whirlpool |
$245.53
|
| Rate for Payer: Meridian Medicaid |
$140.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$214.84
|
| Rate for Payer: PACE SWMI |
$204.61
|
| Rate for Payer: PHP Medicare Advantage |
$204.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$335.56
|
| Rate for Payer: Priority Health Medicare |
$204.61
|
| Rate for Payer: Priority Health Narrow Network |
$335.56
|
| Rate for Payer: UHC Medicare Advantage |
$210.75
|
|
|
PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 60100
|
| Min. Negotiated Rate |
$48.14 |
| Max. Negotiated Rate |
$172.75 |
| Rate for Payer: Aetna Commercial |
$101.97
|
| Rate for Payer: Aetna Medicare |
$76.10
|
| Rate for Payer: BCBS Complete |
$50.55
|
| Rate for Payer: BCBS MAPPO |
$76.10
|
| Rate for Payer: BCBS Trust/PPO |
$172.75
|
| Rate for Payer: BCN Commercial |
$161.26
|
| Rate for Payer: BCN Medicare Advantage |
$76.10
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$109.58
|
| Rate for Payer: Cofinity Commercial |
$101.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.10
|
| Rate for Payer: Healthscope Commercial |
$91.32
|
| Rate for Payer: Healthscope Whirlpool |
$91.32
|
| Rate for Payer: Meridian Medicaid |
$50.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.90
|
| Rate for Payer: PACE SWMI |
$76.10
|
| Rate for Payer: PHP Medicare Advantage |
$76.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.87
|
| Rate for Payer: Priority Health Medicare |
$76.10
|
| Rate for Payer: Priority Health Narrow Network |
$107.87
|
| Rate for Payer: UHC Medicare Advantage |
$78.38
|
|
|
PR BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 41100
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$824.68 |
| Rate for Payer: Aetna Commercial |
$140.36
|
| Rate for Payer: Aetna Medicare |
$104.75
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$104.75
|
| Rate for Payer: BCBS Trust/PPO |
$824.68
|
| Rate for Payer: BCN Commercial |
$276.59
|
| Rate for Payer: BCN Medicare Advantage |
$104.75
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$150.84
|
| Rate for Payer: Cofinity Commercial |
$140.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.75
|
| Rate for Payer: Healthscope Commercial |
$125.70
|
| Rate for Payer: Healthscope Whirlpool |
$125.70
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$109.99
|
| Rate for Payer: PACE SWMI |
$104.75
|
| Rate for Payer: PHP Medicare Advantage |
$104.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.33
|
| Rate for Payer: Priority Health Medicare |
$104.75
|
| Rate for Payer: Priority Health Narrow Network |
$189.33
|
| Rate for Payer: UHC Medicare Advantage |
$107.89
|
|
|
PR BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Professional
|
Both
|
$298.00
|
|
|
Service Code
|
HCPCS 41105
|
| Min. Negotiated Rate |
$70.93 |
| Max. Negotiated Rate |
$609.66 |
| Rate for Payer: Aetna Commercial |
$143.88
|
| Rate for Payer: Aetna Medicare |
$107.37
|
| Rate for Payer: BCBS Complete |
$74.48
|
| Rate for Payer: BCBS MAPPO |
$107.37
|
| Rate for Payer: BCBS Trust/PPO |
$609.66
|
| Rate for Payer: BCN Commercial |
$276.59
|
| Rate for Payer: BCN Medicare Advantage |
$107.37
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cofinity Commercial |
$143.88
|
| Rate for Payer: Cofinity Commercial |
$154.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.37
|
| Rate for Payer: Healthscope Commercial |
$128.84
|
| Rate for Payer: Healthscope Whirlpool |
$128.84
|
| Rate for Payer: Meridian Medicaid |
$74.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.74
|
| Rate for Payer: PACE SWMI |
$107.37
|
| Rate for Payer: PHP Medicare Advantage |
$107.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.03
|
| Rate for Payer: Priority Health Medicare |
$107.37
|
| Rate for Payer: Priority Health Narrow Network |
$194.03
|
| Rate for Payer: UHC Medicare Advantage |
$110.59
|
|
|
PR BIOPSY URETHRA
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 53200
|
| Min. Negotiated Rate |
$90.10 |
| Max. Negotiated Rate |
$364.00 |
| Rate for Payer: Aetna Commercial |
$185.52
|
| Rate for Payer: Aetna Medicare |
$138.45
|
| Rate for Payer: BCBS Complete |
$94.60
|
| Rate for Payer: BCBS MAPPO |
$138.45
|
| Rate for Payer: BCBS Trust/PPO |
$364.00
|
| Rate for Payer: BCN Commercial |
$230.17
|
| Rate for Payer: BCN Medicare Advantage |
$138.45
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cofinity Commercial |
$185.52
|
| Rate for Payer: Cofinity Commercial |
$199.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.45
|
| Rate for Payer: Healthscope Commercial |
$166.14
|
| Rate for Payer: Healthscope Whirlpool |
$166.14
|
| Rate for Payer: Meridian Medicaid |
$94.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.37
|
| Rate for Payer: PACE SWMI |
$138.45
|
| Rate for Payer: PHP Medicare Advantage |
$138.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$264.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$225.33
|
| Rate for Payer: Priority Health Medicare |
$138.45
|
| Rate for Payer: Priority Health Narrow Network |
$225.33
|
| Rate for Payer: UHC Medicare Advantage |
$142.60
|
|
|
PR BIOPSY VAGINAL MUCOSA EXTENSIVE
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 57105
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$3,594.02 |
| Rate for Payer: Aetna Commercial |
$191.49
|
| Rate for Payer: Aetna Medicare |
$142.90
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$142.90
|
| Rate for Payer: BCBS Trust/PPO |
$3,594.02
|
| Rate for Payer: BCN Commercial |
$260.95
|
| Rate for Payer: BCN Medicare Advantage |
$142.90
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$191.49
|
| Rate for Payer: Cofinity Commercial |
$205.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.90
|
| Rate for Payer: Healthscope Commercial |
$171.48
|
| Rate for Payer: Healthscope Whirlpool |
$171.48
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.04
|
| Rate for Payer: PACE SWMI |
$142.90
|
| Rate for Payer: PHP Medicare Advantage |
$142.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.78
|
| Rate for Payer: Priority Health Medicare |
$142.90
|
| Rate for Payer: Priority Health Narrow Network |
$208.78
|
| Rate for Payer: UHC Medicare Advantage |
$147.19
|
|
|
PR BIOPSY VAGINAL MUCOSA SIMPLE
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 57100
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$3,206.78 |
| Rate for Payer: Aetna Commercial |
$86.52
|
| Rate for Payer: Aetna Medicare |
$64.57
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCBS MAPPO |
$64.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,206.78
|
| Rate for Payer: BCN Commercial |
$151.98
|
| Rate for Payer: BCN Medicare Advantage |
$64.57
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Cofinity Commercial |
$86.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.57
|
| Rate for Payer: Healthscope Commercial |
$77.48
|
| Rate for Payer: Healthscope Whirlpool |
$77.48
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.80
|
| Rate for Payer: PACE SWMI |
$64.57
|
| Rate for Payer: PHP Medicare Advantage |
$64.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.84
|
| Rate for Payer: Priority Health Medicare |
$64.57
|
| Rate for Payer: Priority Health Narrow Network |
$91.84
|
| Rate for Payer: UHC Medicare Advantage |
$66.51
|
|
|
PR BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 20251
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$910.70 |
| Rate for Payer: Aetna Commercial |
$558.44
|
| Rate for Payer: Aetna Medicare |
$416.75
|
| Rate for Payer: BCBS Complete |
$283.14
|
| Rate for Payer: BCBS MAPPO |
$416.75
|
| Rate for Payer: BCBS Trust/PPO |
$106.88
|
| Rate for Payer: BCN Commercial |
$618.67
|
| Rate for Payer: BCN Medicare Advantage |
$416.75
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$558.44
|
| Rate for Payer: Cofinity Commercial |
$600.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.75
|
| Rate for Payer: Healthscope Commercial |
$500.10
|
| Rate for Payer: Healthscope Whirlpool |
$500.10
|
| Rate for Payer: Meridian Medicaid |
$283.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.59
|
| Rate for Payer: PACE SWMI |
$416.75
|
| Rate for Payer: PHP Medicare Advantage |
$416.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.48
|
| Rate for Payer: Priority Health Medicare |
$416.75
|
| Rate for Payer: Priority Health Narrow Network |
$646.48
|
| Rate for Payer: UHC Medicare Advantage |
$429.25
|
|
|
PR BIOPSY VERTEBRAL BODY OPEN THORACIC
|
Professional
|
Both
|
$787.00
|
|
|
Service Code
|
HCPCS 20250
|
| Min. Negotiated Rate |
$252.19 |
| Max. Negotiated Rate |
$595.41 |
| Rate for Payer: Aetna Commercial |
$513.35
|
| Rate for Payer: Aetna Medicare |
$383.10
|
| Rate for Payer: BCBS Complete |
$264.80
|
| Rate for Payer: BCBS MAPPO |
$383.10
|
| Rate for Payer: BCBS Trust/PPO |
$556.70
|
| Rate for Payer: BCN Commercial |
$569.80
|
| Rate for Payer: BCN Medicare Advantage |
$383.10
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cofinity Commercial |
$551.66
|
| Rate for Payer: Cofinity Commercial |
$513.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.10
|
| Rate for Payer: Healthscope Commercial |
$459.72
|
| Rate for Payer: Healthscope Whirlpool |
$459.72
|
| Rate for Payer: Meridian Medicaid |
$264.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$402.26
|
| Rate for Payer: PACE SWMI |
$383.10
|
| Rate for Payer: PHP Medicare Advantage |
$383.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$550.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$595.41
|
| Rate for Payer: Priority Health Medicare |
$383.10
|
| Rate for Payer: Priority Health Narrow Network |
$595.41
|
| Rate for Payer: UHC Medicare Advantage |
$394.59
|
|
|
PR BIOPSY VESTIBULE MOUTH
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 40808
|
| Min. Negotiated Rate |
$57.30 |
| Max. Negotiated Rate |
$547.85 |
| Rate for Payer: Aetna Commercial |
$114.77
|
| Rate for Payer: Aetna Medicare |
$85.65
|
| Rate for Payer: BCBS Complete |
$60.16
|
| Rate for Payer: BCBS MAPPO |
$85.65
|
| Rate for Payer: BCBS Trust/PPO |
$547.85
|
| Rate for Payer: BCN Commercial |
$249.22
|
| Rate for Payer: BCN Medicare Advantage |
$85.65
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$123.34
|
| Rate for Payer: Cofinity Commercial |
$114.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.65
|
| Rate for Payer: Healthscope Commercial |
$102.78
|
| Rate for Payer: Healthscope Whirlpool |
$102.78
|
| Rate for Payer: Meridian Medicaid |
$60.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.93
|
| Rate for Payer: PACE SWMI |
$85.65
|
| Rate for Payer: PHP Medicare Advantage |
$85.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.81
|
| Rate for Payer: Priority Health Medicare |
$85.65
|
| Rate for Payer: Priority Health Narrow Network |
$155.81
|
| Rate for Payer: UHC Medicare Advantage |
$88.22
|
|
|
PR BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 56605
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$2,173.43 |
| Rate for Payer: Aetna Commercial |
$79.02
|
| Rate for Payer: Aetna Medicare |
$58.97
|
| Rate for Payer: BCBS Complete |
$39.58
|
| Rate for Payer: BCBS MAPPO |
$58.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,173.43
|
| Rate for Payer: BCN Commercial |
$114.27
|
| Rate for Payer: BCN Medicare Advantage |
$58.97
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$84.92
|
| Rate for Payer: Cofinity Commercial |
$79.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.97
|
| Rate for Payer: Healthscope Commercial |
$70.76
|
| Rate for Payer: Healthscope Whirlpool |
$70.76
|
| Rate for Payer: Meridian Medicaid |
$39.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.92
|
| Rate for Payer: PACE SWMI |
$58.97
|
| Rate for Payer: PHP Medicare Advantage |
$58.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.80
|
| Rate for Payer: Priority Health Medicare |
$58.97
|
| Rate for Payer: Priority Health Narrow Network |
$83.80
|
| Rate for Payer: UHC Medicare Advantage |
$60.74
|
|
|
PR BIOPSY VULVA/PERINEUM EACH ADDL LESION
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 56606
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$1,893.96 |
| Rate for Payer: Aetna Commercial |
$39.37
|
| Rate for Payer: Aetna Medicare |
$29.38
|
| Rate for Payer: BCBS Complete |
$19.46
|
| Rate for Payer: BCBS MAPPO |
$29.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,893.96
|
| Rate for Payer: BCN Commercial |
$56.68
|
| Rate for Payer: BCN Medicare Advantage |
$29.38
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$42.31
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$35.26
|
| Rate for Payer: Healthscope Whirlpool |
$35.26
|
| Rate for Payer: Meridian Medicaid |
$19.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.85
|
| Rate for Payer: PACE SWMI |
$29.38
|
| Rate for Payer: PHP Medicare Advantage |
$29.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.66
|
| Rate for Payer: Priority Health Medicare |
$29.38
|
| Rate for Payer: Priority Health Narrow Network |
$41.66
|
| Rate for Payer: UHC Medicare Advantage |
$30.26
|
|
|
PR BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT
|
Professional
|
Both
|
$661.00
|
|
|
Service Code
|
HCPCS 33933
|
| Min. Negotiated Rate |
$251.71 |
| Max. Negotiated Rate |
$1,305.43 |
| Rate for Payer: Aetna Commercial |
$536.72
|
| Rate for Payer: BCBS Complete |
$264.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,305.43
|
| Rate for Payer: BCN Commercial |
$627.12
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Meridian Medicaid |
$264.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$635.15
|
| Rate for Payer: Priority Health Narrow Network |
$635.15
|
|
|
PR BLADDER INSTILLATION ANTICARCINOGENIC AGENT
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 51720
|
| Min. Negotiated Rate |
$27.48 |
| Max. Negotiated Rate |
$2,209.35 |
| Rate for Payer: Aetna Commercial |
$57.70
|
| Rate for Payer: Aetna Medicare |
$43.06
|
| Rate for Payer: BCBS Complete |
$28.85
|
| Rate for Payer: BCBS MAPPO |
$43.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,209.35
|
| Rate for Payer: BCN Commercial |
$102.88
|
| Rate for Payer: BCN Medicare Advantage |
$43.06
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$62.01
|
| Rate for Payer: Cofinity Commercial |
$57.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.06
|
| Rate for Payer: Healthscope Commercial |
$51.67
|
| Rate for Payer: Healthscope Whirlpool |
$51.67
|
| Rate for Payer: Meridian Medicaid |
$28.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.21
|
| Rate for Payer: PACE SWMI |
$43.06
|
| Rate for Payer: PHP Medicare Advantage |
$43.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.70
|
| Rate for Payer: Priority Health Medicare |
$43.06
|
| Rate for Payer: Priority Health Narrow Network |
$69.70
|
| Rate for Payer: UHC Medicare Advantage |
$44.35
|
|
|
PR BLADDER PRESSURE MEASUREMENT DURING FILLING
|
Professional
|
Both
|
$686.00
|
|
|
Service Code
|
HCPCS 51726
|
| Min. Negotiated Rate |
$274.40 |
| Max. Negotiated Rate |
$3,274.93 |
| Rate for Payer: Aetna Commercial |
$382.30
|
| Rate for Payer: Aetna Medicare |
$285.30
|
| Rate for Payer: BCBS Complete |
$274.40
|
| Rate for Payer: BCBS MAPPO |
$285.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,274.93
|
| Rate for Payer: BCN Commercial |
$441.76
|
| Rate for Payer: BCN Medicare Advantage |
$285.30
|
| Rate for Payer: Cash Price |
$548.80
|
| Rate for Payer: Cash Price |
$548.80
|
| Rate for Payer: Cofinity Commercial |
$382.30
|
| Rate for Payer: Cofinity Commercial |
$410.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.30
|
| Rate for Payer: Healthscope Commercial |
$342.36
|
| Rate for Payer: Healthscope Whirlpool |
$342.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.56
|
| Rate for Payer: PACE SWMI |
$285.30
|
| Rate for Payer: PHP Medicare Advantage |
$285.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$480.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$488.48
|
| Rate for Payer: Priority Health Medicare |
$285.30
|
| Rate for Payer: Priority Health Narrow Network |
$488.48
|
| Rate for Payer: UHC Medicare Advantage |
$293.86
|
|
|
PR BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL
|
Professional
|
Both
|
$452.00
|
|
|
Service Code
|
HCPCS 38206
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$1,117.35 |
| Rate for Payer: Aetna Commercial |
$108.58
|
| Rate for Payer: Aetna Medicare |
$81.03
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$81.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,117.35
|
| Rate for Payer: BCN Commercial |
$120.21
|
| Rate for Payer: BCN Medicare Advantage |
$81.03
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cofinity Commercial |
$116.68
|
| Rate for Payer: Cofinity Commercial |
$108.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.03
|
| Rate for Payer: Healthscope Commercial |
$97.24
|
| Rate for Payer: Healthscope Whirlpool |
$97.24
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.08
|
| Rate for Payer: PACE SWMI |
$81.03
|
| Rate for Payer: PHP Medicare Advantage |
$81.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.18
|
| Rate for Payer: Priority Health Medicare |
$81.03
|
| Rate for Payer: Priority Health Narrow Network |
$178.18
|
| Rate for Payer: UHC Medicare Advantage |
$83.46
|
|
|
PR BLDR IRRIGATION SMPL LAVAGE &/INSTLJ
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 51700
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$1,655.16 |
| Rate for Payer: Aetna Commercial |
$39.84
|
| Rate for Payer: Aetna Medicare |
$29.73
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS MAPPO |
$29.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,655.16
|
| Rate for Payer: BCN Commercial |
$89.53
|
| Rate for Payer: BCN Medicare Advantage |
$29.73
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$39.84
|
| Rate for Payer: Cofinity Commercial |
$42.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.73
|
| Rate for Payer: Healthscope Commercial |
$35.68
|
| Rate for Payer: Healthscope Whirlpool |
$35.68
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.22
|
| Rate for Payer: PACE SWMI |
$29.73
|
| Rate for Payer: PHP Medicare Advantage |
$29.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.09
|
| Rate for Payer: Priority Health Medicare |
$29.73
|
| Rate for Payer: Priority Health Narrow Network |
$48.09
|
| Rate for Payer: UHC Medicare Advantage |
$30.62
|
|
|
PR BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 15821
|
| Min. Negotiated Rate |
$312.59 |
| Max. Negotiated Rate |
$903.57 |
| Rate for Payer: Aetna Commercial |
$708.54
|
| Rate for Payer: Aetna Medicare |
$528.76
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$528.76
|
| Rate for Payer: BCBS Trust/PPO |
$312.59
|
| Rate for Payer: BCN Commercial |
$903.57
|
| Rate for Payer: BCN Medicare Advantage |
$528.76
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$708.54
|
| Rate for Payer: Cofinity Commercial |
$761.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$528.76
|
| Rate for Payer: Healthscope Commercial |
$634.51
|
| Rate for Payer: Healthscope Whirlpool |
$634.51
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$555.20
|
| Rate for Payer: PACE SWMI |
$528.76
|
| Rate for Payer: PHP Medicare Advantage |
$528.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$671.64
|
| Rate for Payer: Priority Health Medicare |
$528.76
|
| Rate for Payer: Priority Health Narrow Network |
$671.64
|
| Rate for Payer: UHC Medicare Advantage |
$544.62
|
|
|
PR BLEPHAROPLASTY UPPER EYELID
|
Professional
|
Both
|
$925.00
|
|
|
Service Code
|
HCPCS 15822
|
| Min. Negotiated Rate |
$31.71 |
| Max. Negotiated Rate |
$675.35 |
| Rate for Payer: Aetna Commercial |
$514.35
|
| Rate for Payer: Aetna Medicare |
$383.84
|
| Rate for Payer: BCBS Complete |
$268.16
|
| Rate for Payer: BCBS MAPPO |
$383.84
|
| Rate for Payer: BCBS Trust/PPO |
$31.71
|
| Rate for Payer: BCN Commercial |
$675.35
|
| Rate for Payer: BCN Medicare Advantage |
$383.84
|
| Rate for Payer: Cash Price |
$740.00
|
| Rate for Payer: Cash Price |
$740.00
|
| Rate for Payer: Cofinity Commercial |
$514.35
|
| Rate for Payer: Cofinity Commercial |
$552.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.84
|
| Rate for Payer: Healthscope Commercial |
$460.61
|
| Rate for Payer: Healthscope Whirlpool |
$460.61
|
| Rate for Payer: Meridian Medicaid |
$268.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$403.03
|
| Rate for Payer: PACE SWMI |
$383.84
|
| Rate for Payer: PHP Medicare Advantage |
$383.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$255.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$488.73
|
| Rate for Payer: Priority Health Medicare |
$383.84
|
| Rate for Payer: Priority Health Narrow Network |
$488.73
|
| Rate for Payer: UHC Medicare Advantage |
$395.36
|
|
|
PR BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 15823
|
| Min. Negotiated Rate |
$46.61 |
| Max. Negotiated Rate |
$905.03 |
| Rate for Payer: Aetna Commercial |
$708.65
|
| Rate for Payer: Aetna Medicare |
$528.84
|
| Rate for Payer: BCBS Complete |
$369.47
|
| Rate for Payer: BCBS MAPPO |
$528.84
|
| Rate for Payer: BCBS Trust/PPO |
$46.61
|
| Rate for Payer: BCN Commercial |
$905.03
|
| Rate for Payer: BCN Medicare Advantage |
$528.84
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$761.53
|
| Rate for Payer: Cofinity Commercial |
$708.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$528.84
|
| Rate for Payer: Healthscope Commercial |
$634.61
|
| Rate for Payer: Healthscope Whirlpool |
$634.61
|
| Rate for Payer: Meridian Medicaid |
$369.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$555.28
|
| Rate for Payer: PACE SWMI |
$528.84
|
| Rate for Payer: PHP Medicare Advantage |
$528.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$672.45
|
| Rate for Payer: Priority Health Medicare |
$528.84
|
| Rate for Payer: Priority Health Narrow Network |
$672.45
|
| Rate for Payer: UHC Medicare Advantage |
$544.71
|
|
|
PR BLEPHAROTOMY DRAINAGE ABSCESS EYELID
|
Professional
|
Both
|
$434.00
|
|
|
Service Code
|
HCPCS 67700
|
| Min. Negotiated Rate |
$73.91 |
| Max. Negotiated Rate |
$498.19 |
| Rate for Payer: Aetna Commercial |
$148.38
|
| Rate for Payer: Aetna Medicare |
$110.73
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS MAPPO |
$110.73
|
| Rate for Payer: BCBS Trust/PPO |
$498.19
|
| Rate for Payer: BCN Commercial |
$416.84
|
| Rate for Payer: BCN Medicare Advantage |
$110.73
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cofinity Commercial |
$159.45
|
| Rate for Payer: Cofinity Commercial |
$148.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.73
|
| Rate for Payer: Healthscope Commercial |
$132.88
|
| Rate for Payer: Healthscope Whirlpool |
$132.88
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$116.27
|
| Rate for Payer: PACE SWMI |
$110.73
|
| Rate for Payer: PHP Medicare Advantage |
$110.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.79
|
| Rate for Payer: Priority Health Medicare |
$110.73
|
| Rate for Payer: Priority Health Narrow Network |
$200.79
|
| Rate for Payer: UHC Medicare Advantage |
$114.05
|
|
|
PR BLUE TIDAL
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 00072
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
|
|
PR BONE GRAFT ANY DONOR AREA MAJOR/LARGE
|
Professional
|
Both
|
$1,228.00
|
|
|
Service Code
|
HCPCS 20902
|
| Min. Negotiated Rate |
$175.09 |
| Max. Negotiated Rate |
$859.60 |
| Rate for Payer: Aetna Commercial |
$363.94
|
| Rate for Payer: Aetna Medicare |
$271.60
|
| Rate for Payer: BCBS Complete |
$183.84
|
| Rate for Payer: BCBS MAPPO |
$271.60
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: BCN Commercial |
$400.72
|
| Rate for Payer: BCN Medicare Advantage |
$271.60
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cofinity Commercial |
$363.94
|
| Rate for Payer: Cofinity Commercial |
$391.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.60
|
| Rate for Payer: Healthscope Commercial |
$325.92
|
| Rate for Payer: Healthscope Whirlpool |
$325.92
|
| Rate for Payer: Meridian Medicaid |
$183.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$285.18
|
| Rate for Payer: PACE SWMI |
$271.60
|
| Rate for Payer: PHP Medicare Advantage |
$271.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.74
|
| Rate for Payer: Priority Health Medicare |
$271.60
|
| Rate for Payer: Priority Health Narrow Network |
$418.74
|
| Rate for Payer: UHC Medicare Advantage |
$279.75
|
|
|
PR BONE GRAFT ANY DONOR AREA MINOR/SMALL
|
Professional
|
Both
|
$891.00
|
|
|
Service Code
|
HCPCS 20900
|
| Min. Negotiated Rate |
$114.81 |
| Max. Negotiated Rate |
$623.70 |
| Rate for Payer: Aetna Commercial |
$239.32
|
| Rate for Payer: Aetna Medicare |
$178.60
|
| Rate for Payer: BCBS Complete |
$120.55
|
| Rate for Payer: BCBS MAPPO |
$178.60
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: BCN Commercial |
$574.19
|
| Rate for Payer: BCN Medicare Advantage |
$178.60
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$257.18
|
| Rate for Payer: Cofinity Commercial |
$239.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.60
|
| Rate for Payer: Healthscope Commercial |
$214.32
|
| Rate for Payer: Healthscope Whirlpool |
$214.32
|
| Rate for Payer: Meridian Medicaid |
$120.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$187.53
|
| Rate for Payer: PACE SWMI |
$178.60
|
| Rate for Payer: PHP Medicare Advantage |
$178.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.75
|
| Rate for Payer: Priority Health Medicare |
$178.60
|
| Rate for Payer: Priority Health Narrow Network |
$275.75
|
| Rate for Payer: UHC Medicare Advantage |
$183.96
|
|
